Accident Piper PA-28-140 N20BS,
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ASN Wikibase Occurrence # 360812
 
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Date:Wednesday 23 February 1994
Time:11:50 LT
Type:Silhouette image of generic P28A model; specific model in this crash may look slightly different    
Piper PA-28-140
Owner/operator:Redwood Aviation Enterprises
Registration: N20BS
MSN: 28-22373
Year of manufacture:1966
Total airframe hrs:4298 hours
Engine model:LYCOMING O-320
Fatalities:Fatalities: 0 / Occupants: 2
Aircraft damage: None
Category:Accident
Location:Santa Rosa, CA -   United States of America
Phase: Standing
Nature:Training
Departure airport:
Destination airport:Sacramento, CA (SMF
Investigating agency: NTSB
Confidence Rating: Accident investigation report completed and information captured
Narrative:
PRIOR TO DEPARTING ON A TRAINING FLIGHT, THE FLIGHT INSTRUCTOR AND A STUDENT WERE SEATED IN THE AIRPLANE ATTEMPTING TO START THE ENGINE. THE ENGINE TURNED OVER SLOWLY, BUT FAILED TO START. THE FLIGHT INSTRUCTOR BELIEVED THE PROBLEM TO BE WITH THE STARTER. SHE DECIDED TO EXIT THE AIRPLANE TO REPOSITION THE PROPELLER IN ORDER TO FREE THE STARTER. IN THE PROCESS, THE PROPELLER ROTATED AND STRUCK THE HEAD AND SHOULDER OF THE FLIGHT INSTRUCTOR. THE STUDENT INSIDE THE AIRPLANE DID NOT MANIPULATE THE CONTROLS WHILE THE INSTRUCTOR WAS OUTSIDE. EXAMINATION OF THE COCKPIT CONTROLS REVEALED THAT THE MASTER SWITCH WAS OFF, MIXTURE AND THROTTLE CONTROLS AT IDLE, AND THE MAGNETO SWITCH WAS ON.

Probable Cause: A failure of the pilot-in-command to ensure that the powerplant controls were configured properly before moving the aircraft propeller. Inadequate planning/decision making was a factor in this accident.

Accident investigation:
cover
  
Investigating agency: NTSB
Report number: LAX94LA136
Status: Investigation completed
Duration: 8 months
Download report: Final report

Sources:

NTSB LAX94LA136

History of this aircraft

Other occurrences involving this aircraft
3 March 1985 N8468R Paul Rued 0 Healdsburg, CA sub

Location

Revision history:

Date/timeContributorUpdates
16-Mar-2024 11:24 ASN Update Bot Added

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