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Messages - pjossi

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Summary:

A gear collapse of a V35B Bonanza at Deer Valley Airport was caused by a slip of the pilot confusing the gear and flap levers. There was no danger of nor any injuries. The incident caused complete economic loss of the aircraft.

Introduction:

Since there has been some interest expressed in this incident here, I recently checked with my attorney who has approved public discussion of the aviation facts and aspects of this incident. I will first review the underlying facts, then discuss causes and lessons. My hope is that such careful review will help reduce the number of such incidents in the future.

Background:

Prior to this incident, I had flown ~900 hours in my fixed gear 1969 Cardinal which I had purchased pre-solo. During private training I had done more touch and goes in that aircraft than I can count and got in the habit of reaching over to the right during the latter part of the landing roll and bringing up the flaps. During training for my CFI, I had performed at least 100 short field landings in which I would bring up the flaps to get the weight on the main gear and improve braking effectiveness. I did my commerical training in a T-tailed Arrow IV back when retractable time was required. Prior to this incident, we had purchased for a jointly owned LLC a 1977 V-tailed Bonanza of which I then owned 50%. I had had 10 hours of dual training in this Bonanza as part of the Bonanza Pilot Profieciency Program and 5 hours of solo flight for insurance purposes. In total, I had 43 hours in retractables.

On September 4, 2021:

On this day, I had decided to take a friend for a breakfast flight up to Prescott, AZ, both to enjoy the flight and check out the situation with the new terminal there and the required shuttle to Suzie's Skyway restaurant; this in preparation for the upcoming fly-in breakfast on October 23. I decided to take the V-tailed Bonanza since I wanted to accumulate more time in it.

After breakfast, we went to overfly the nearby gliderport. We then headed south back to KDVT and I let my friend fly part of the way back and the descent back into the valley. It was somewhat difficult losing all the required altitude and, as we approached KDVT, I noticed we were inside the circle denoting their class D. I immediately began a turn to the west and called tower. It turned out that we were still above their airspace so no violation. They had us continue flying to the north to provide spacing for a slower aircraft which was also coming in to land from the north.

We were then turned back south to use an extended base with an original assignment for runway 7L. I had requested and expected to eventually be transferred to 7R as the airplane was hangared on the southwest part of the field. This eventually happened. As I had promised myself during my commercial training, I went through the GUMPS checklist 3 times:  on the extended base (essentially the downwind check), on base proper, and on final. All 3 times 3 green lights were observed and confirmed by the passenger.

We were a bit fast initially on final but got the speed under control and landed. Once on the runway, I noticed we were a bit fast on rollout and made a comment about this. The passenger said he had noticed a bit of a tailwind as well. As we approached two possible turnouts, I decided I would bring up the flaps and, as in my Cardinal, reached over to the right and pulled the lever up.

The next thing I heard was a scraping sound and I then noticed the propeller tips bending over. Clearly I had brought up the gear instead of the flaps and uttered some profanity. We slid about 150' down the runway and came to a stop. What a sinking feeling - literally and figuratively! The passenger asked if we should get out now. I said to start doing so and turned off the fuel. The tower then called and asked if we had a problem. I confirmed we did and then turned off the electrical.

Exiting onto the right wing I could see some fuel dripping out onto the asphalt at the right wing tip but no smoke or other sign of fire. We moved a bit away from the airplane and started to assess.

My first thought and the first thing the passenger said was "What the Hxxx? Isn't there supposed to be a squat switch to prevent this sort of thing?" Looking at the airplane, the nose gear was completely collapsed and the main gear mostly but not fully retracted in an asymmetric way with the right gear more retracted. The right wing tip had struck the pavement and the right flap had hit. But overall at this point the damage didn't look too terribly bad.

Shortly a truck from airport management arrived and they called the NTSB to determine if the aircraft could be moved. We took a whole bunch of photos to record the incident and sent some to the NTSB.

Next thing I did was contact the co-owner of the LLC and explain the situation. Then my flight instructor to get his take on this.

The NTSB approved moving the aircraft and it took about an hour to locate a tow truck that had a crane for picking up wrecks. They lifted the aircraft over to the ramp area and we set it down using some concrete blocks to support the nose.

Next few days:

After inspecting the photographs, the NTSB determined there was no substantial damage and it was an incident rather than an accident. I described the entire incident to the FAA. Their basic determination was that this was a slip type of error -- intending to do one thing but instead mistakenly doing something else. They felt qualifications and training were more than adequate and had no required or recommended training. I believe they felt the incident itself was more than enough of a lesson in what not to do.

We obtained an estimate for repairs of $163,000, which exceeeded the insured hull value of $150,000, and so the insurance company decided to total the aircraft and took possession.

Causes:

In considering this incident, my thoughts are that there were two primary causes and two possible secondary causes:

Primacy of learning was likely one primary cause. I had literally 20 times as much time in a fixed gear Cardinal as in retractables, much of it taking up the flaps during touch and goes or during short field landings. By contrast, only a portion of the 10 hours of dual instruction in the Bonanza had dealt with not making configuration changes during the landing roll out. So during a quick decision while landing, the initial and much longer training took over. During my 5 hours of solo time in the Bonanza, I may have already started reverting to taking up the flaps, though can't remember.

Flying both fixed gear and retractables was another likely primary cause. The day before this incident I had been giving a lesson in the Cardinal and had taken up the flaps during the landing roll out, as was my habit. Several airline pilot friends have noted that in the airlines they learned a long time ago that this sort of thing could happen and so the pilots are trained for one type and only fly that type. Additionally, all crew use exactly the same procedures every time, even if there are multiple ways to accomplish a task. This consistency reinforces the proper habit to be used when flying the plane. Switching back and forth between airplanes with different procedures means the habits may be the wrong habit for the airplane.

A secondary cause likely included failure maintain a sterile cockpit. There was no operational reason to comment on the fast ground speed or be having a conversation about the tailwind at that point. This may have decreased my attention to identifying the flap lever properly. My friend previously worked as an aeronautical engineer and we always have way to much to talk about. I realize I had never discussed with him the need for a sterile cockpit during takeoff, pattern, and landing.

Another possible secondary cause was a failure of the squat switch. Since this was unfortunately not checked prior to the insurance company taking possession of the plane, the official read by the FAA is that this aspect is unknown. We were rolling fairly slowly, but the squat switch still allowing the gear to come up if there is lift from the flaps or a bump is one of the reasons that the Bonanza training is  - don't change the configuration until stopped off the runway.

A contributing factor was likely the fact that older Bonanzas have the gear lever on the right versus on the left in other aircraft and in newer Bonanzas. If the flaps had been on the right, as in my Cardinal, my reaching over and lifting the lever likely would not have caused the gear collapse.

Lessons regarding procedures:

I think there are several lessons here.

Firstly, if one is going to be flying a mixure of types, such as fixed gear and retractables, it is best to adopt a set of procedures which will work in both types so that the proper habits are easier to maintain. In this case, don't touch the flaps or trim or other configuration during landing rollout, even though that may be fine in a fixed gear airplane.

Clearly in some cases, like touch and goes or short field landings, it will be necessary to makes changes during roll-out, but then likely best to explicitly brief them on downwind or before entering the pattern and reinforce this by manually identifying the controls to be used.

I don't know that this lesson applies as strongly or broadly when just flying fixed gear or transitioning completely to retractables.

Secondly, use multiple layered procedures during required configuration changes. Especially when moving between aircraft and/or types, perhaps best to first identify the control by feel, then state out loud what one's hand is on, then move it. And use the pinky finger to push up on the flap shaped flap lever since that won't work well on a wheel shaped gear lever.

As in handling firearms, multiple layers of safety should reduce the chances of an undesired outcome by a multiplicative effect. I have begun the process of training myself to not bring the flaps up on the runway - even in the Cardinal. I think I will be able to change this long standing habit. Combined with other changes, hopefully this will never happen again (knock on wood).

What I am presently doing with airplanes:

This was clearly a very unfortunate destruction of a rather nice Bonanza through a seemingly simple pilot error. Ugh. Several friends have noted that perhaps I would be well advised to switch to a C210 for a faster airplane since the layout of the controls will be more similar to the C177 Cardinal. While I agree this is true, the simple fact of the matter is that I vastly prefer the control balance and speed of the V-tailed Bonanzas.

Since a gear collapse on roll-out is not likey dangerous, I will start looking again for a V35B Bonanza come the new year. Presently I am working on taking delivery of a new to me glider and finishing up my helicopter add-on. My insurance on all aircraft, including gliders, will apparently be up about 30% over the next several years. I guess I will just pay it to continue to enjoy flying the aircraft I like.

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