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Task-saturated pilot seriously injured in crash

By NTSB · December 11, 2023 ·

The pilot reported that, at the conclusion of the positioning flight, she amended her initial plan to enter the traffic pattern at the airport in Hamilton, Alabama, due to potential conflicts with other traffic, and instead completed an entry into a left downwind leg of the traffic pattern.

The sequence of events left her “task saturated” and she failed to complete the before-landing checklist and properly configure the twin-engine airplane’s fuel system for landing by switching from the auxiliary to the main fuel tanks.

While on final approach to the runway the left engine lost power and the airplane began a “lazy Vmc roll to the left.”

The pilot attempted to continue ahead toward the runway, but realized the airplane would not be able to clear power lines, so she maneuvered for a forced landing.

The pilot was seriously injured when the airplane crashed into the ground.

Examination of the airplane at the accident site confirmed that the left fuel selector was in the “Aux” position. Published in the Pilot’s Operating Handbook and placarded between the fuel selectors was: “USE AUX TANKS AND CROSSFEED IN LEVEL FLIGHT ONLY.”

Given this information, it is likely that the pilot’s failure to properly configure the airplane’s fuel system while maneuvering for landing resulted in a loss of engine power to the airplane’s left engine due to fuel starvation and the subsequent forced landing.

Probable Cause: The pilot’s failure to properly configure the airplane’s fuel system, which resulted in a loss of engine power on the left engine due to fuel starvation.

NTSB Identification: 104435

To download the final report. Click here. This will trigger a PDF download to your device.

This December 2021 accident report is provided by the National Transportation Safety Board. Published as an educational tool, it is intended to help pilots learn from the misfortunes of others.

About NTSB

The National Transportation Safety Board is an independent federal agency charged by Congress with investigating every civil aviation accident in the United States and significant events in the other modes of transportation, including railroad, transit, highway, marine, pipeline, and commercial space. It determines the probable causes of accidents and issues safety recommendations aimed at preventing future occurrences.

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Comments

  1. Bill Story says

    December 12, 2023 at 10:18 am

    Sorry for you conventional twin guys/gals. I fly a Cessna Skymaster and don’t have that engine failure problem, I’ll just loose thrust if I have an engine out. FYI.

  2. Bill Story says

    December 12, 2023 at 10:15 am

    G-U-M-P-S!!! If you are like me and don’t used a pre-landing checklist, you can survive with the acronym “GUMPS” You know: Gas Under carriage Mixture Props Switches/Seatbelts!
    Just my thoughts, BILLS

    • John says

      January 1, 2024 at 1:03 pm

      Agreed….. Claiming “task saturation” as the reason for the crash? The woman was most certainly behind the aircraft.
      There’s no reason for “task saturation” when flying in the pattern on a beautiful sunny day. Sadly, it seems many pilots today are not being trained to the level of proficiency that was expected “back in the day”. With the luxury of GPS, moving map displays, real time weather radar overlayed in the aircraft, all the things that used to be difficult to master, are now simply given to the pilot with no need of diffusing out anything long form the way we used to. My point is, to claim task saturation is a ludicrous response. And as to your comment above, hell, I’ve been saying “GUMP” to myself every time I’m on final for the last 40 years!

      • Tom Curran says

        January 1, 2024 at 11:06 pm

        OK; I’m just curious:

        Pilot was a 4,600-hour ATP with 570 hours in type. “Task saturation” were the words she used to describe what happened.

        How would you describe it?

        (“…behind the airplane” has already been mentioned.)

  3. Wylbur Wrong says

    December 12, 2023 at 7:19 am

    Task saturation — me thinks this is a euphemism for being behind the airplane.

    Those tank switches (assuming it had to be done specifically for each engine) need to be done at altitude, before entering the airport environment. That way if you do have a fuel issue and lose an engine, you can declare an emergency and get in to land rather than having to break off and re-enter to match traffic already there, which is what she had to do and then lost both engines resulting in a destroyed aircraft. Note: she was an ATP. I wonder if she was out of practice with single pilot ops and didn’t follow the checklist(s).

    • Tom Curran says

      December 12, 2023 at 9:45 am

      Straight from the article/NTSB Final Report: “The sequence of events left her “task saturated” and she failed to complete the before-landing checklist and properly configure the twin-engine airplane’s fuel system for landing ….”

  4. John says

    December 12, 2023 at 7:14 am

    Unless that aux tank was out of fuel the engine will keep running. Also a VMC roll at approach power? Did she firewall the operating engine? That would not be a smart move in that configuration. So many questions…

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