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Page 1 of 17
ACCID/091210/03-12
MINISTRY OF WORKS AND TRANSPORT
DIRECTORATE OF AIRCRAFT ACCIDENT INVESTIGATION ACCIDENT REPORT – EXECUTIVE SUMMARY
Aircraft Registration ZU-FCY Date of Accident 12 September 2010 Time of
Accident 0724Z
Type of Aircraft LANCAIR LEGACY 2000 Type of Operation Private
Pilot- In - Command Licence Type Private Age 60 Licence Valid Yes Pilot- In - Command Flying Experience
Total Flying Hours 1 400.0 Hours on Type 60.0
Last point of departure Omaruru Aerodrome, Namibia Next point of intended landing Eros Aerodrome, Namibia (FYWE)
Location of the accident site with reference to eas ily defined geographical points (GPS readings if possible)
Open field 19 nm West of the town of Okahandja (GPS position; South 22º 00’96 East 016º 34’45) Meteorological Information Surface wind; Easterly/12 knots, Visibility: >10km Number of people on board 1 + 1 No. of people injured 0 No. of people killed 0
Synopsis
On 12 September 2010, a pilot, accompanied by a passenger departed from Omaruru aerodrome on a private visual flight rules (VFR) flight in a Lancair Legacy 2000 aircraft with the registration ZU-FCY. There intended destination being Eros aerodrome, near Windhoek where they have planned to land and uplift fuel in order to continue with their journey back to South Africa. The pilot stated, while approximately 11 minutes from landing at Eros aerodrome he experienced a sudden loss of engine power. He attempted to restart the engine, but was unsuccessful in doing so. He then made the decision to execute a forced landing on a dirt road he had identified from the air as a suitable area. He executed a right turn in order to line up with the road but as the aircraft descent he observed power lines ahead of him, which require immediate evasive action and he executed a left turn in order to avoid colliding with the wires. He then realigned the aircraft with the road and aimed to touchdown after the cattle gate. At approximately 50 feet above ground level (AGL) he selected the landing gear down as well as full flaps. He was unable to reach the road and using all the elevator control available he mush the aircraft into the bush type of terrain. During the forced landing the landing gear broke off with the aircraft came to rest in an upright position approximately 50 meters from the first point of touchdown. Nobody was injured in the accident but the aircraft was substantially damage. The pilot was a holder of a valid private pilot license. His aviation medical certificate was valid without any restrictions. The last Annual Inspection that was certified on the aircraft prior to the accident was carried out on 30 September 2009 at 28.8 airframe hours. The aircraft had flown a further 36.1 hours since the last inspection was certified.
Probable Cause
Unsuccessful forced landing following an engine malfunction in-flight.
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AIRCRAFT ACCIDENT REPORT
Name of Owner/Operator : J.M. Onderstall
Manufacturer : Lancair International
Model : Lancair Legacy 2000
Nationality : South African
Registration Mark : ZU-FCY
Place : 19 nm West of Okahandja
Date : 12 September 2010000T0055553 March 2008
Time :
All times given in this report are Co-ordinated Universal Time (UTC).
Disclaimer:
The report is given without prejudice to the rights of the Directorate of Aircraft Accident
Investigations, which are reserved.
Purpose of the Investigation:
In terms of ICAO Annex 13, this report was compiled in the interest of the promotion of
aviation safety and the reduction of risk of aviation accident or incidents and not to establish
legal liability.
This report contains fact relating to aircraft accidents or incidents which have been
determined at the time of issue. The report may therefore be revised should new and
substantive facts be made available to the investigator(s).
1. FACTUAL INFORMATION
1.1 History of Flight:
1.1.1 On 12 September 2010, a pilot, accompanied by a passenger departed from Omaruru
aerodrome on a private visual flight rules (VFR) flight in a Lancair Legacy 2000 aircraft
Page 3 of 17
with the registration ZU-FCY. There intended destination being Eros aerodrome, near
Windhoek where they have planned to land and uplift fuel in order to continue with
their journey back to South Africa.
1.1.2 The pilot stated while flying at flight level (FL) 55, approximately 11 minutes from
landing at Eros aerodrome the engine experienced a sudden loss of engine power.
He attempted an engine restart, by selecting the fuel pump on high and then to the low
but was unsuccessful in getting the engine to restart. He then made the decision to
execute a forced landing on a dirt road he had identified from the air as a suitable
area.
1.1.3 He executed a right turn in order to line up with the road but as the aircraft descent he
observed power lines ahead of him, which require immediate evasive action and he
executed a left turn in order to avoid colliding with the wires. He again realigned the
aircraft with the road and aimed to touchdown past the cattle gate. At approximately
50 feet above ground level (AGL) he selected the landing gear down as well as full
flaps. He was unable to reach the road and using all the elevator control available he
mush the aircraft into bush type of terrain. During the forced landing the landing gear
broke off and the aircraft came to rest in an upright position approximately 50 meters
from the first point of touchdown. Nobody was injured in the accident but the aircraft
was substantially damage.
1.1.4 Prior to touchdown the pilot transmitted a Mayday call on the Eros tower frequency
118.7 MHz, indicating his position at the time.
1.1.5 According to available records there was still ample fuel onboard the aircraft at the
time of the accident. Available records indicated that 112 litres of Avgas was uplifted
at Eros aerodrome on 10 September 2010, when the aircraft was refuelled en route to
Omaruru aerodrome.
1.1.6 The accident occurred during daylight conditions at a geographical position that was
determined to be South 22º 00’96 East 016º 34’45 at an elevation of 4 362 feet above
mean sea level (AMSL).
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1.2 Injuries to Persons:
Injuries Pilot Crew Pass. Other
Fatal - - - -
Serious - - - -
Minor - - - -
None 1 - 1 -
1.3 Damage to Aircraft:
1.3.1 The aircraft, which consisted of a composite airframe structure, was substantially
damage during the impact sequence.
Figure 1. A view of the aircraft as it came to rest next to the dirt road.
1.4 Other Damage:
1.4.1 Minor damage was caused to the vegetation in the immediate surroundings.
Page 5 of 17
1.5 Personnel Information:
Nationality South Africa
Licence No 0270235997 Gender Male Age 60
Licence valid Yes Type Endorsed Yes
Ratings Night Rating, Test Pilot Rating Class 2
Medical Expiry Date 31 October 2010
Restrictions To have reading spectacles in the aircraft.
Previous Accidents None
Flying Experience:
Total Hours 1 400.00
Total Past 90 Days 25.00
Total on Type Past 90 Days 16.42
Total on Type 60.00
1.6 Aircraft Information:
Airframe:
Type Lancair Legacy 2000
Serial No. L2K-305
Manufacture Lancair International
Year of Manufacture 2009
Total Airframe Hours (At time of Accident) 64.90
Last Annual Inspection (Hours & Date) 28.08 30 September 2009
Hours since Last Annual Inspection 36.82
Authority to Fly (Issue Date) 20 October 2009
C of R (Issue Date) Present owner 25 February 2009
Operating Categories Normal
Page 6 of 17
Engine:
Type Teledyne Continental IO-550N
Serial No. 820561-R
Hours since New 64:00
Hours since Overhaul T.B.O. not yet reached
Propeller:
Type Hartzell HC-J3YF-1RF/F 73910-3
Serial No. JN111B
Hours since New 64:00
Hours since Overhaul T.B.O. not yet reached
1.7 Meteorological Information:
1.7.1 The following weather information was obtained from the pilot’s questionnaire.
Wind direction Easterly Wind speed ± 12 kt Visibility Good
Temperature unknown Cloud cover None Cloud base None
Dew point unknown
1.8 Aids to Navigation:
1.8.1 The aircraft was equipped with standard navigation equipment, which was serviceable
at the time of accident.
1.9 Communications:
1.9.1 The pilot broadcast a Mayday call on the Eros tower frequency 118.7 MHz.
1.9.2 There was no reported communication problem between the pilot and the air traffic
controller who handle the flight.
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1.10 Aerodrome Information:
1.10.1 The accident did not occur at or near an aerodrome.
1.10 Flight Recorders:
1.11.1 The aircraft was not equipped with a Flight Data Recorders (FDR) and Cockpit Voice
Recorders (CVR), nor was it required by the regulation to be fitted to this type of
aircraft.
1.12 Wreckage and Impact Information:
1.12.1 The aircraft came to rest in an upright position approximately 50 m past the first point
of touchdown. All three landing gear assemblies broke off after touchdown, with the
lower fuselage surface sustaining damage as the aircraft skidded on its belly before it
came to rest. All three propeller blades were bend backwards, with wing leading edge
damage being evident on the right wing, resulting in the fuel tank being ruptured with
fuel leaking from the tank. The left wing fuel tank remained intact and still contained a
substantial amount of fuel.
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Figure 2: Various photos of the accident terrain and damage sustained by the aircraft.
Figure 3 : Various photos indicating the damage to the right wing leading edge as well as the propeller.
Page 9 of 17
Figure 4: Fuel leaking from the right wing tank following impact damage.
1.13 Medical and Pathological Information:
1.13.1 Not applicable.
1.14 Fire:
1.14.1 There was no pre- or post-impact fire.
1.15 Survival Aspects:
1.15.1 The pilot and the passengers were properly secure by making use of the aircraft
equipped safety harness and did not sustain any injuries during the impact sequence
which was associated with low kinetic forces within the level of human tolerance.
Page 10 of 17
Figure 5 . A view of the cockpit which remained intact following the impact sequence.
1.16 Tests and Research:
1.16.1A substantial amount of fuel was still present in the aircraft during the on-site
investigation. Fuel samples were taken from both fuel tanks and the fuel were found to
be of the correct grade and free of contamination.
1.16.2 The aircraft wreckage was recovered from the accident site and transported to Eros
aerodrome for safe keeping and further investigation.
1.16.3 Engine Teardown Inspection:
The engine was removed from the wreckage and was taken to an approved engine
maintenance facility where a teardown inspection was performed. The purpose of the
investigation was to determine whether the engine failed due to a mechanical
malfunction. The following observations were made:
Engine Model Teledyne Continental IO-550N
Engine Serial No. 820561-R
Fuel flow divider
Part # 646433-3A2
Serial # C07FA136R
The diaphragm and filter assembly was undamaged.
The unit was opened during the teardown inspection and still
contained a substantial amount of fuel. The unit was
Page 11 of 17
checked for any dirty that might have been contained inside,
but were found to be clean. The filter screen inside the unit
was undamaged.
Fuel Control Unit
Part # 653353-3A2,
Serial # AO7FA134R
The unit was undamaged and all the linkages were still
attached. The throttle valve moved freely and was
undamaged. A small amount of fuel was still present in
the fuel line when the unit was removed.
Spark plugs
Champion RHM32E
The spark plugs, which were undamaged, were removed and
tested, and no anomalies were noted. They displayed a
greyish colour that was consistent with normal engine
operation.
HT Leads The High Tension Leads were found to be in an overall good
condition and undamaged.
Fuel Pump
Part # 655921-1A1,
Serial # 807FA161R
The unit was undamaged. It was bench tested in accordance
with the Continental Engine Continuous Flow Fuel Injection
System manual at 700 and 2700rpm. It met all the
requirements as stipulated in the manual.
Magneto’s (Alpha)
Part # BL-500556-1,
Serial # DO7FA140R,
DO7FA138R
Both magneto’s were found undamaged and in an overall
good condition. They were still secured to the engine and the
High Tension leads were attached. (Unable to check the
timing). Both units were subjected to a bench test procedure
and functioned satisfactorily.
Oil Filter
The filter was still attached to the engine.
The oil displayed a dark brown colour.
No metal particles were observed in the filter unit.
Gear drive train The gear train was undamaged and intact.
Fuel nozzles
Part # 5239
All the fuel nozzles were removed from the cylinders.
They were found to be free of any obstructions.
Cylinders The cylinders appeared to be in good overall condition and
were within dimensional limitations.
Pistons & Rings
The pistons were in a good condition with no evidence of
carbon build-up or visible wear/scouring.
None of the rings were broken.
Main bearings &
Big-end bearings
All the bearings were in a good overall condition and
displayed sufficient evidence of lubrication.
Connecting rods All six connecting rods were found to be in a good overall
Page 12 of 17
condition/undamaged.
Camshaft
Part # 654084,
Serial # Z07EA140
The camshaft was found to be in a good overall condition
including the gear drive assembly.
Crankshaft The crankshaft was found to be in an overall good condition.
Oil pick-up tube and
sump assembly
The sump assembly on the engine suffered minor impact
damage in the area of the drain plug. The pick-up screen
was free of debris and found to be undamaged.
Approximately 10 litres of oil were drained from the engine,
which displayed a dark brown colour.
Oil pump The oil pump was found undamaged and in a good condition.
Oil Cooler The Oil cooler was found undamaged and in a good
condition.
1.16.4 Additional observation during engine teardown inspection.
It was noted that the engine rpm pick-up, which was located on the right-hand
magneto (obtaining its impulses from the magnetic field generated by the rotating
magneto) was found to be loose in its housing. Glue needs to be applied to the pick-
up unit before it gets inserted into its housing in order to ensure it remains secure. The
unit was found to be only partially secluded in the housing (no sign of any glue
being applied to the pick-up) and the possibility that the position of the pick-up might
have resulted that the actual engine rpm was not being transferred to the
instrumentation could not be ruled out. (See next page for a photo of the magneto and
the pick-up).
Page 13 of 17
Figure 6. A view of the right magneto with the rpm pick-up partially secluded.
Conclusion:
With the available evidence gathered during the teardown inspection, no mechanical
evidence could be found to substantiate the statement made by the pilot
with reference to the engine failing in-flight. The engine was found to be in an overall
good condition.
1.16.5 Avionics Data Card:
The aircraft primary flight display (PFD) consisted of a MGL Avionics Odyssey
electronic flight instrument system (EFIS), which contained a removable data card.
The unit was found undamaged and the data card was removed and made available to
an approved avionics maintenance facility to assist with the download of data, which
required special software. The system was however not set-up to record any data of
any of the flights since installation in the aircraft, which include the accident flight.
1.17 Organizational and Management Information:
1.17.1 The aircraft was on a private flight from Omaruru aerodrome to Eros aerodrome in
Namibia.
Page 14 of 17
1.17.2 The aircraft was in possession of a valid Authority to Fly that was issued on 20
October 2009 and was to expire on 30 September 2010.
1.18 Additional Information:
1.18.1 Over-flight Authorization:
An over-flight and landing authorization for the aircraft ZU-FCY was obtained from the
aviation Regulatory Authority in Namibia before the pilot commenced with the flight
from South Africa to Namibia. He was issued with permit No. CH27/2857/2010, which
was valid for the period 9 to 17 September 2010.
1.19 Useful or Effective Investigation Techniques:
1.19.1 None.
2. ANALYSIS
2.1.1 The pilot of the aircraft was properly certified and qualified under the Civil Aviation
Regulations to conducted the flight. No evidence indicated any pre-existing medical
condition that might have adversely affected the pilot’s performance during the
accident flight. The pilot had broadcast a Mayday call on the Eros tower frequency
after he made the decision to execute a forced landing.
2.1.2 The accident aircraft was properly maintained in accordance with the Civil Aviation
Regulation provisions of a non type certified aircraft (NTCA).
2.1.3 During the bench test of the magnetos, which operated satisfactorily in all aspects it
was noted that the engine rpm pick-up located on the right-hand magneto was not
properly secluded in its housing with glue. The possibility that the pick-up might have
provided erratic or erroneous information on the primary flight display could not be
ruled out. However during a discussion with the pilot following the accident he
indicated that the engine power loss was sudden with no engine cockpit indication out
of the norm that he could picked up an impending failure during the flight. With the
Page 15 of 17
pilot also being the owner of the aircraft and have flown the aircraft since new he
mentioned that this was the first time he had experienced any technical problem with
the aircraft.
2.1.4 The investigation determined that the engine was;
(i) Mechanically in a good condition with no evidence found that could have
contributed or have caused the engine to loss power.
(ii) Two of the engine fuel system units still contained fuel during the engine
teardown inspection indicating that fuel was delivered to the engine, thereby
ruling out fuel starvation. Ample fuel was still in the aircraft at the time of the
accident and the fuel samples that were taken indicate it to be free of
contamination.
(iii) Approximately 10 litres of oil was drained from the engine during the teardown
inspection. All bearings and associated lubricated surfaces were found to be in
an overall good condition.
(iv) No evidence of overheating was visible to any of the engine components.
(v) Both magnetos functioned satisfactorily during the bench test procedure and
the spark plugs displayed a greyish colour consisted with normal engine
operation.
(vi) It was noted that the engine rpm pick-up located on the right-hand magneto
was not properly secluded in its housing with glue.
(vii) The exhaust system displayed minor impact damage.
2.1.5 The cause the engine power loss resulting in a forced landing in open bush type of
terrain could not be determined with certainty.
3. CONCLUSION
3.1 Findings
3.1.1 The pilot was the holder of a valid private pilot licence and had the aircraft type
endorsed in his logbook.
3.1.2 The aircraft was in possession of a valid Authority to Fly.
3.1.3 The pilot was in possession of a valid over-fly and landing authorisation that was
Page 16 of 17
issued by the Namibian aviation authorities prior to him commencing with the flight
from South Africa to Namibia.
3.1.4 The last fuel uplift prior to the accident was on 10 September 2010 when 112 litres of
Avgas was uplifted at Eros aerodrome.
3.1.5 There was ample fuel remaining in the aircraft at the time of the accident, with fuel
leaking from the right wing tank, which was ruptured due to impact damage.
3.1.6 Fuel samples that were taken on the scene indicate that the fuel was of the correct
grade and free of contamination.
3.1.7 Following an engine malfunction in-flight the pilot broadcast a Mayday call on the Eros
tower frequency 118.7 MHz.
3.1.8 The engine was removed from the wreckage and was subjected to a teardown
inspection at an approved engine maintenance facility. No evidence of mechanical
malfunction that could have contributed or have caused the engine to fail was
detected.
3.1.9 The engine rpm pick-up, which was located on the right-hand magneto was found to be
only partially secluded in its housing (no sign of any glue being applied to the pick-up
to ensure it remain secure).
3.1.10 The aircraft was found to be within the weight and balance limits at the time of
accident.
3.1.11 Good weather conditioned prevailed at the time of the flight and was not considered to
be a factor in this accident.
3.2 Probable Cause/s:
3.2.1 Unsuccessful forced landing following an engine malfunction in-flight.
3.3 Contributory Factor/s:
Page 17 of 17
3.3.1 None.
4. SAFETY RECOMMENDATIONS
4.1 None.
5. APPENDICES
5.1 None.
Compiled by:
...........................
Titus Shuungula Date: .........................
Investigator-in-charge
.........................................
Herman T. Hipondoka Date: .........................
Co–Investigator
For Director of Aircraft Accident Investigation
Released by:
......................................
Erkki Nghimtina (MP) Date: .........................
MINISTER: MINISTRY OF WORKS AND TRANSPORT