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Thu, Dec 20, 2018

NTSB Releases Factual Report From Christmas Eve, 2017 Accident

Some Told The Board That The Pilot Involved Was 'Safe', Others Disagreed

The pilot of a Cessna 340 which went down during takeoff from Bartow (FL) Municipal Airport (KBOW) on Christmas Eve last year was called by some a "safe" pilot, though others had a differing view of his piloting skills. The pilot and four passengers aboard the aircraft were fatally injured in the accident.

According to the NTSB's factual report on the accident, the pilot filed an IFR flight plan on a Garmin GPS device and received an IFR clearance from the Tampa air traffic control tower. The KBOW air traffic control tower was closed at the time of the accident.

According to two fixed base operator (FBO) employees at KBOW, the pilot requested that the airplane be towed from the hangar to the ramp. The pilot stated that he wanted a tow so that he did not have to taxi next to the other hangars because of reduced visibility and dense fog. About 0645, the five occupants boarded the airplane and the FBO employees towed it to the ramp.

The FBO employees stated that the pilot started the engines and that they watched as the airplane very slowly taxied toward the end of runway 9L. The fog limited their visibility to about 400 ft. They could no longer see the airplane in the dense fog, so they moved to an area on the ramp closer to the runway. The pilot contacted Tampa Approach at 0710 for his IFR clearance. The FBO employees heard an increase in engine noise consistent with an engine run-up, and about 0715, they heard the airplane take off but they could not see the airplane because of the dense fog. The engines "sounded strong and [were] operating at full power" during the takeoff. They heard two tire "chirps" on the runway, then the sound of the airplane was consistent with a climb. They then heard an explosion on the east side of the airport and drove toward the explosion to find the airplane on fire. One of the FBO employees recorded a video of the airplane taxiing on the ramp toward the runway and another video of the takeoff.

The video captured by the FBO employee was 46 seconds long. While recording the video, the employee was located near the middle of the ramp and about 1/2 mile from the end of runway 9L. The accident airplane is not visible due to the dense fog. The sound of the engines is audible. The video pans from right to left and appears to follow the sounds of the airplane during the takeoff roll. At 26 and 28 seconds, two distinct chirps are heard. The video ends while the engines are still audible.

A helicopter pilot based at KBOW observed the airplane taxiing on the ramp toward the runway. He recorded a video of the airplane taxiing on the ramp in the dense fog. He heard the airplane take off about 12 minutes later. During the takeoff, he heard a 'pop' similar to an engine backfire and about 3 seconds later, heard the explosion near the end of runway 9L. He and a colleague drove to the accident site, where they found the airplane engulfed in flames and saw the FBO employees nearby. He estimated that the runway visual range at the time was 600 to 800 ft due to the fog.

The mechanic who maintained the airplane stated that the pilot always flew with his feet flat on the floor and not on the rudder pedals. He also stated that the pilot never flew dangerously or recklessly. He added that the pilot's personal logbooks were always kept on the back shelf in the airplane.

The pilot's personal assistant stated that he always flew the airplane a couple of days before a flight with passengers. She stated that everyone she talked to described him as a good pilot and diligent with his pilot duties.

An acquaintance of the pilot, who also was the pilot's flight instructor in 2002, recounted flying the accident airplane with the pilot. He stated that the pilot mentioned an in-flight engine failure he experienced in the accident airplane. The pilot told him that he continued to his destination rather than making a precautionary single-engine landing because the logistics of diverting were too difficult. The acquaintance also stated that he and the pilot were supposed to fly the accident airplane together in early 2017. On the morning of the planned flight, he checked the weather conditions, which were about 1/4 mile visibility and 100 ft ceilings with dense fog. He told the pilot that they could not complete the flight because of the weather, and the pilot responded that, legally, they were allowed to fly under Part 91. The acquaintance had not talked to the accident pilot since that canceled flight.

However, a local airplane mechanic, who was a business acquaintance of the pilot, stated that he flew with the pilot one time and then refused to fly with him again. The acquaintance stated that he was not a safe pilot and took unnecessary risks.

The mechanic who maintained the airplane stated that, two days before the accident, at the request of the pilot, he moved the co-pilot seat aft and adjusted the rear seats forward. He also stated that the accident airplane had a known autopilot issue; if the autopilot was engaged on the ground, it would command the elevator trim full nose-down. He understood this issue was a result of the autopilot's gyros not being level on the ground, which caused the autopilot to sense and attempt to compensate for a high pitch attitude. He stated that the accident pilot was aware of this autopilot issue.

The airplane logbooks did not reveal any past maintenance discrepancies or write-ups related to the autopilot or elevator trim.

(Image from NTSB report)

FMI: Full factual report

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