CEN13FA496

The pilot's improper decision to attempt continued flight after a momentary loss of engine power with usable runway remaining. Contributing to the accident were the pilot's premature retraction of the landing gear, the loss of engine power due to fuel system water contamination, and the pilot's failure to detect the fuel contamination during the preflight inspection.

**This report was modified on 1/5/2015. Please see the public docket for this accident to view the original report. ** The airplane experienced a total loss of engine power during takeoff from a runway that had a usable length of 6,827 feet; however, the pilot initiated the takeoff from a taxiway intersection, which left only about 5,313 feet of runway remaining. After the loss of engine power, the airplane descended to about 10 feet above ground level (agl) with the landing gear retracted; about half of the runway length remained. Engine power was restored, and the airplane subsequently climbed to between about 300 and 400 agl. The engine again lost power, and the airplane subsequently stalled and impacted a field. The landing gear remained retracted. Typically, the landing gear should be retracted after liftoff when the airplane has reached an altitude where, in the event of an engine failure or other emergency requiring an aborted takeoff, the airplane could no longer be landed on the runway. The airplane arrived at the departure airport 3 days before the accident and was parked on the ramp. There was a trace of precipitation at the airport on the day of arrival and no precipitation on subsequent days. Examination of the airplane revealed the presence of water in the fuel diaphragm and fuel servo. No evidence of fuel contamination in the fuel pumps was found, and no reports of fuel contamination or engine power loss of airplanes that had been refueled from the fuel pumps before and after the accident were made. Examination of the fuel filler caps revealed that the cap components were in place and that both caps were in place and secure. When water was poured onto the fuel caps when they were placed and secured back into position, they exhibited leakage into the fuel tank; however, the extent of deformation around the filler neck due to accident damage was unknown. During the most recent annual inspection, it was noted that the fuel cap O-rings were replaced because of water contamination of the fuel system. No record was found indicating that maintenance personnel pressurized the fuel tanks to check for fuel cap leakage in accordance with the airplane manufacturer's maintenance instructions. No internal obstruction was noted in the fuel system that would have precluded the pilot from detecting water in the system while sumping it during the preflight inspection.

There were no reports of fuel contamination and/or loss of engine power by airplanes fueled at the airport self-serve fuel pump where the accident airplane was fueled from. Examination of the airport fuel facility did not reveal any fuel contamination. The flight instructor, who provided the pilot's Mooney airplane training, stated that he taught the pilot to use the fuel strainer to check the fuel and that it takes about 10-15 minutes for contaminants to settle. They discussed that Mooney airplanes can allow water through the fuel cap O-rings. According to the Mooney M20J Pilot's Operating Handbook and FAA Approved Airplane Flight Manual, Section 4, Normal Procedures, the Preflight Inspection checklist precedes the Before Engine Starting Check checklist. The Preflight Inspection stated to sump the fuel tank sump drains. According to the Airplane Flying Handbook (FAA-H-8083-3A), Chapter 11, Transition to Complex Airplanes, Takeoff and Climb: "Normally, the landing gear should be retracted after lift-off when the airplane has reached an altitude where, in the event of an engine failure or other emergency requiring an aborted takeoff, the airplane could no longer be landed on the runway. This procedure, however, may not apply to all situations. Landing gear retraction should be preplanned, taking into account the length of the runway, climb gradient, obstacle clearance requirements, the characteristics of the terrain beyond the departure end of the runway, and the climb characteristics of the particular airplane." The pilot was issued a third class airman medical certificate dated December 2, 2011, with the following limitation: "Holder must wear corrective lenses for distant vision while exercising the privileges of his airman certificate." The FAA Final Forensic Toxicology Fatal Accident Report for the pilot reported: No carbon monoxide was detected in blood, cyanide testing was not performed, no ethanol was detected in vitreous, and no listed drugs were detected in urine. An autopsy of the pilot was performed by the Jackson County Medical Examiner, Kansas City, Missouri. The cause of death was listed as multiple blunt force trauma. The MKC automated surface observing system recorded at 1345: wind - 170 degrees at 7 knots, wind variable between 120 and 210 degrees; visibility - 10 statute miles. sky condition – broken at 5,000 feet above ground level, temperature 28 degrees Celsius, dew point 14 degrees Celsius, altimeter setting - 30.12 inches of mercury. Rain totals at MKC for August 15, 16, and 17, 2013, were recorded as: trace of precipitation or less than 0.01 inches, no precipitation, and no precipitation, respectively. There was no precipitation recorded on the day of the accident. The main wreckage, which included the fuselage, attached wings and empennage with their respective control surfaces, engine, and propeller was located in a field about 0.25 nautical miles southwest of the departure end of runway 19 at an elevation of about 705 feet mean sea level. The airplane was oriented in an upright position and a tail to nose heading of approximately 170 degrees. The landing gear jack screw extension was consistent with the landing gear in the retracted position. The flap jack screw extension was consistent with flaps in the 10-degree position. The empennage trim jack screw extension was consistent for a setting for a flaps 10 degree takeoff. There was no evidence of soot or fire. The fuselage exhibited aft crushing to about the rear cabin entry door frame and cockpit roof was broken open. The engine compartment exhibited aft crushing damage. The leading edge of both wings exhibited aft crushing about 1/3 wing chord. The deformation included upward bending near the forward portion of both wing tank fuel filler necks. Both wing fuel tanks were broken open. Both wings exhibited about a 90-degree crush angle. The outer wing section of the left wing was had greater relative aft deformation and was curled upwards. The empennage was bent laterally toward the right about 10 degrees and the left horizontal stabilizer and its elevator tip was bent upwards. Flight control continuity from all the flight control surface to the cockpit controls was confirmed. Both wing fuel caps were in place and the fuel cap locking tabs were in the down position and flush with the top of the fuel caps. The fuel caps were removed and all of the fuel cap components were in place. A brown colored stain was present on the left fuel tank filler neck flange. Both fuel caps were replaced and locked into place and water was poured over both fuel caps, which resulted in the water pouring out from the underside of both fuel caps. The fuel caps were interchanged and water was poured over each fuel cap, which resulted in the same effect. Examination of the fuel tanks revealed that a black colored sealant was present along the bottom of the wing fuel tank ribs. The sealant did not cover any of the holes at the bottom of the ribs. There were no obstructions in the fuel sump system. The fuel line from the fuel selector to the engine was broken open and separated. The fuel selector knob was bent and positioned near the left fuel tank selection. The ignition key switch was at the BOTH position. The mixture, propeller, and throttle control knobs were in the forward position. Examination of the engine confirmed control continuity of the mixture, propeller, and throttle controls from their respective engine accessories to the cockpit controls. Borescope inspection of the engine cylinders revealed no anomalies. The engine was turned through by rotating the propeller by hand, during which air was drawn in and expelled through each top spark plug hole. Valve train continuity was confirmed during the engine rotation. The magneto was rotated by hand and electrical continuity through the ignition harness was confirmed. Examination of the airplane engine revealed the presence of a liquid consistent with water present in the fuel servo in a proportion estimated to half of that of remaining liquid that was consistent with 100 low lead aviation fuel. The fuel injector diaphragm was disassembled, and a liquid consistent with water was present under the diaphragm. The airplane instrument panel was damaged by impact forces. The airplane's hour meter was separated from the instrument panel and three of the digits were between values. The hour meter indicated 1,176.2. The tachometer was of digital type, and no reading was obtained. N9201R was a 1978 Mooney M20J, serial number 24-0614, airplane was purchased by Air McRoyal, LLC (the aircraft registration application was signed by the pilot as president of McRoyal Industries, Inc. on December 14, 2012) on December 31, 2013. The airplane was powered by a Lycoming IO-360-A3B6D, serial number L-19288-51A, engine. The engine was equipped with a Bendix RSA-5AD1, serial number 67270, fuel servo. The last annual inspection of the airframe was dated January 8, 2013. A work order for the annual inspection, which was also a presale inspection, referenced an airplane total time of 2,423.84 and a tachometer time of 2,423.84. The work order for the inspection listed Item 7 with the following: Discrepancy: Replace fuel cap O-rings Note: Water in fuel system Corrective Action: Replaced the fuel cap O-rings The parts listed under Item 7 were two MS29513-010 Fuel Cap O-Rings, Small and two MS29513-338 Fuel Cap O-Rings. The work order and airframe logbook did not cite that the fuel tanks were pressurized to check for leaks of the fuel caps. The Mooney M20J Service and Maintenance Manual, Section 28-00-01, Fuel Filler Cap Maintenance and Assembly, stated in part: 3. The sealing capability of each cap assembly should be checked periodically and at each annual inspection. This can be accomplished per the following procedures: A. Remove cap assembly from wing filler port and inspect o'ring (1) for any