NTSB Identification: LAX06LA094.
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Accident occurred Tuesday, January 24, 2006 in Mariposa, CA
Probable Cause Approval Date: 08/30/2007
Aircraft: Cessna T210N, registration: N4791C
Injuries: 1 Minor,1 Uninjured.
NTSB investigators may not have traveled in support of this investigation and used data provided by various sources to prepare this aircraft accident report.
The aircraft collided with multiple obstacles during a forced landing in rough terrain following a catastrophic engine failure. While en route about 6,000 feet mean sea level, one cylinder in the engine indicated a loss of exhaust gas and cylinder head temperature. Thereafter, an increasingly strong vibration was felt, oil dispersed onto the front windscreen, and all engine power was lost. During the landing flare, the airplane impacted an oak tree, a fence, and a rock outcrop. The engine was found separated from the airplane's firewall. Also, the number 6 cylinder was observed broken from the engine case. The engine was torn down and the case was opened. The evidence of the torque values found on all the engine through-bolts, combined with the fretting signature at the base of the number 6 cylinder, and the oil residue at the union of the case halves, indicates that when the cylinders were installed on the engine their respective bolts were inadequately torqued. During an interview with the mechanic who had replaced the 6 cylinders on the engine, he reported that he followed the instructions in TCM's maintenance manual when he had replaced the cylinders in May 2005. He said he torqued the nuts on the cylinders to about 500 inch pounds. According to TCM's maintenance manual, 1989 edition, the required torque for the through-bolts was 690 to 710 inch pounds. By 1996, TCM had revised its manual by issuance of service bulletin 96-7. In that bulletin the required torque was increased to between 790 to 810 inch pounds.
The National Transportation Safety Board determines the probable cause(s) of this accident to be: The failure of the maintenance personnel to follow the procedures in the TCM maintenance manual and adequately torque the engine through-bolts, which led to the separation of the No. 6 cylinder and the catastrophic failure of the engine.
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