Aviation Accident Summaries

Aviation Accident Summary ERA21FA263

Mercer, TN, USA

Aircraft #1

N333LZ

CIRRUS SR22

Analysis

While climbing to cruise altitude during a cross-country flight, the pilot advised the air traffic controller that the airplane was experiencing engine issues associated with manifold pressure and requested to divert to an airport where the airplane was maintained; however, this was not the nearest airport. The pilot further stated that he was not declaring an emergency. The controller cleared the airplane to the requested airport with a descent to 3,000 ft msl at the pilot’s discretion, and subsequently transferred communications to the controller at the diversion airport. The controller advised the pilot that he needed to maintain 2,500 ft msl, which was the minimum vectoring altitude (MVA). The airplane gradually descended below the MVA, and the controller advised the pilot that a closer airport was located on his right side (about 10 nm); however, the pilot continued to the diversion airport (about 27 nm). When the controller asked if the pilot was going to use the airframe parachute, the pilot indicated that he was attempting to land in a field. The airplane impacted trees and came to rest in a field about 10 miles from the diversion airport. Data retrieved from the airplane’s Recoverable Data Module (RDM) revealed that the manifold air pressure (MAP) limit was exceeded about 10 minutes into the flight, reaching a peak recorded value of 53.9 inches. The maximum normal operating range for MAP for the airplane according to the pilot operating handbook (POH) was 36.5 inches. The MAP fluctuated from the time of the exceedance until the end of the data, about 19 minutes later. Examination of the engine revealed that the left turbocharger waste gate contained a small metal fragment wedged between the housing and the valve, which was about 75% closed. Metallurgical examination of the fragment revealed it was consistent with stainless steel. Review of the airplane’s maintenance records revealed that the left turbocharger was replaced 3 months before the accident during the most recent annual inspection. It is likely that the maintenance performed on the airplane during the inspection resulted in foreign object deposited into the exhaust system and jammed the waste gate, resulting in an overboost of the turbocharger and partial loss of engine power.

Factual Information

HISTORY OF FLIGHTOn June 21, 2021, about 0930 central daylight time, a Cirrus Design Corporation SR22T, N333LZ, was substantially damaged when it was involved in an accident near Mercer, Tennessee. The pilot was fatally injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. According to air traffic control communications obtained from the Federal Aviation Administration, the airplane departed Memphis International Airport (MEM), Memphis, Tennessee, about 0900 on an instrument flight rules flight plan with an intended destination of Asheville Regional Airport (AVL), Asheville, North Carolina. The pilot established radio communication with air traffic control while climbing through 3,000 ft mean sea level (msl) to 15,000 ft msl; however, after the airplane climbed to 6,600 ft msl, it began to lose altitude. The pilot advised the controller that the airplane was experiencing engine issues associated with manifold pressure. The pilot then requested to divert to McKellar-Sipes Regional Airport (MKL), Jackson, Tennessee, where the airplane was maintained. The pilot further stated that he was not declaring an emergency. The controller cleared the airplane to MKL with a descent to 3,000 ft msl at the pilot’s discretion. The controller then transferred communications to the MKL controller. The pilot contacted the MKL controller while the airplane was descending through 3,900 ft msl for 3,000 ft msl. He asked for the RNAV RWY20 approach to MKL and requested a descent at pilot’s discretion to maintain airspeed. The controller advised the pilot that he needed to maintain 2,500 ft msl, which was the minimum vectoring altitude (MVA) for the area. The airplane subsequently gradually descended below the MVA and the controller advised the pilot that Bolivar Airport (M08), Bolivar, Tennessee, was located on his right side; however, the pilot continued to MKL (At that time, M08 was located about 10 nautical miles (nm) east, and MKL was located about 27 nm northeast of the airplane’s position; respectively). When the airplane was at 720 ft msl, the pilot reported that he was attempting to land in a field. The controller advised the pilot that radar contact was lost; however, he asked the pilot the altitude of the airplane, and the pilot stated 600 ft msl. The controller also asked the pilot if he intended to use the parachute, and the pilot responded that he was trying for a field. No further communications were received from the pilot. AIRCRAFT INFORMATIONReview of the airplane’s maintenance records revealed that the most recent annual inspection was completed on March 3, 2021, at an airframe and engine total time of 1,217.9 hours. During the annual inspection, the left turbocharger was replaced with an overhauled turbocharger. According to the airplane pilot operating handbook (POH), the Cirrus Airframe Parachute System (CAPS) is designed to lower the aircraft and its passengers to the ground in the event of a life-threatening emergency. CAPS deployment is likely to result in damage to the airframe and, possibly injury to aircraft occupants, its use should not be taken lightly…. If a forced landing on an unprepared surface is required CAPS activation is recommended unless the pilot in command concludes there is a high likelihood that a safe landing can be accomplished. If a condition requiring a forced landing occurs over rough or mountainous terrain…CAPS activation is strongly recommended….” AIRPORT INFORMATIONReview of the airplane’s maintenance records revealed that the most recent annual inspection was completed on March 3, 2021, at an airframe and engine total time of 1,217.9 hours. During the annual inspection, the left turbocharger was replaced with an overhauled turbocharger. According to the airplane pilot operating handbook (POH), the Cirrus Airframe Parachute System (CAPS) is designed to lower the aircraft and its passengers to the ground in the event of a life-threatening emergency. CAPS deployment is likely to result in damage to the airframe and, possibly injury to aircraft occupants, its use should not be taken lightly…. If a forced landing on an unprepared surface is required CAPS activation is recommended unless the pilot in command concludes there is a high likelihood that a safe landing can be accomplished. If a condition requiring a forced landing occurs over rough or mountainous terrain…CAPS activation is strongly recommended….” WRECKAGE AND IMPACT INFORMATIONThe wreckage was located in a field on the edge of a tree line about 10 miles southwest of MKL. The airplane came to rest upright on a magnetic heading of 360°. Several large tree branches were lying beside the wreckage. The left wing leading edge exhibited tree impression marks along its length. All three landing gear were separated but remained under the main wreckage. The empennage remained attached to the fuselage. The horizontal stabilizer remained attached to the empennage and exhibited impact damage. The vertical stabilizer remained attached to the empennage; however, the rudder was separated from the vertical stabilizer at the top and mid-point hinges. Control cable continuity was established to all flight control surfaces from the flight controls to the cockpit. The Cirrus Airframe Parachute System (CAPS) was found intact. The safety pin was out of the handle, but the system was not activated. Both wings remained attached to the fuselage and exhibited impact damage. The engine remained attached to the fuselage; however, the engine mounts were fractured in numerous places. The propeller remained attached to the engine. One propeller blade was fractured and found about 20 ft from the main wreckage. The spinner dome was crushed and creased and contained tree bark. The airplane was recovered to a salvage facility for further examination. The bottom spark plugs were removed and exhibited normal wear. The propeller was rotated by hand through 360° and crankshaft continuity was established through the valvetrain. Thumb compression was attained on all cylinders. A lighted borescope was used to examine the pistons, valves, and cylinder walls and all exhibited normal wear. Both turbochargers rotated smoothly by hand. The left exhaust exhibited cracking and melting at the turbocharger attachment flange. The waste gate was removed, and a small metal fragment was wedged between the housing and the valve, which was about 75% closed. The waste gate controller mounting bracket was fractured and the connecting rod was bent. The metal fragment was sent to the National Transportation Safety Board Materials Laboratory for identification. The metallic section was examined using an x-ray fluorescence (XFR) alloy analyzer. The metallic section was consistent with stainless steel. The Recoverable Data Module (RDM) was removed from the vertical stabilizer. It was not damaged. The RDM was partially downloaded on scene and the data included the accident flight in its entirety. The manifold air pressure (MAP) limit was exceeded about 10 minutes into the flight. The maximum normal operating range for MAP for the airplane according to the POH was 36.5 inches. The peak recorded value during the exceedance was 53.9 inches. Additionally, the MAP fluctuated from the time of the exceedance until the end of the data about 19 minutes later. MEDICAL AND PATHOLOGICAL INFORMATIONThe Office of the Medical Examiner, Nashville, Tennessee, performed an autopsy on the pilot. His cause of death was reported as blunt force injuries. Toxicology testing performed by the FAA’s Forensic Services Laboratory on the pilot’s blood and urine identified no evidence of impairing drugs.

Probable Cause and Findings

A partial loss of engine power due to foreign object debris contamination of the left turbocharger wastegate. Contributing to the accident was the pilot’s failure to divert to the nearest airport.

 

Source: NTSB Aviation Accident Database

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