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Accidents · NTSB GAA16CA243 · Final report

Piper PA-28 accident near Crystal River, Florida, May 13, 2016

On May 13, 2016 at about 5:50 pm local time, a 2015 Piper PA-28, registered N991A, was substantially damaged in an accident during takeoff near Crystal River, Florida (Crystal River-Captain Tom Davi airport). It was a personal flight under general aviation rules (Part 91). No one was hurt; 1 person was on board or involved. The weather was visual conditions (good weather).

The NTSB's probable cause their words, unchanged

The student pilot's failure to maintain directional control during the takeoff, which resulted in runway excursion and collision with a ditch. Contributing to the accident was the improper flap retraction procedure employed by the pilot during takeoff.

Source: NTSB aviation accident database, copy made October 5, 2026. Docket and reports at the NTSB.

What the record shows

Date
May 13, 2016 · about 5:50 pm local time
Place
Crystal River, Florida · Crystal River-Captain Tom Davi · map
Type
Accident
Injuries
No one was hurt; 1 person was on board or involved.
Weather
visual conditions (good weather)
Aircraft
Piper PA-28 181, built 2015 · all PA-28s on the register
Registration
N991A · registry record · serial 2843807
Damage
Substantial damage
Flight
Personal flight · general aviation rules (Part 91)

The NTSB's narrative final · quoted from the NTSB record

The student pilot reported that shortly after the airplane rotated during the takeoff, he noticed that the flaps were extended. He further reported that about 20 feet above the ground he retracted the flaps from 25 degrees to zero degrees, and simultaneously encountered wind that pushed the airplane towards the ground and left of centerline. Once the airplane settled on the ground, he attempted to correct back to the center of the runway, but reported that the airplane veered off the runway to the left and impacted a ditch. A postaccident examination revealed substantial damage to the engine mount. According to the student pilot there were no preimpact mechanical failures or malfunctions with the airframe or engine that would have precluded normal operation. A review of recorded data from the automated weather observation station located on the airport, revealed that, about 5 minutes after the accident the wind was 280 degrees true at 6 knots, wind gust 14 knots,  visibility 10 statute miles, and sky clear. The airplane landed on runway 27. The Federal Aviation Administration has published the Airplane Flying Handbook FAA-H-8083-3A (2004). This handbook discusses retraction of the flaps and states in part: Depending on the airplane's altitude and airspeed, it may be wise to retract the flaps intermittently in small increments to allow time for the airplane to accelerate progressively as they are being raised. A sudden and complete retraction of the flaps could cause a loss of lift resulting in the airplane settling into the ground.

The complete narrative as the NTSB published it. The NTSB's docket holds the report as a PDF and any photographs, statements and other documents from the investigation.

The factual record from the NTSB's investigation tables, in plain English

What happened, in order

  1. Abrupt maneuver during takeoff
  2. Other weather encounter during takeoff
  3. Loss of lift during takeoff
  4. Loss of control on ground during takeoff defining event
  5. Attempted remediation/recovery during takeoff
  6. Runway excursion during takeoff
  7. Collision with terrain or object (not controlled flight into terrain) during takeoff

The NTSB's findings

  • cause Personnel issues › Task performance › Use of equip/info › Aircraft control › Pilot
  • cause Aircraft › Aircraft oper/perf/capability › Performance/control parameters › Directional control › Not attained/maintained
  • factor Aircraft › Aircraft systems › Flight control system › TE flap control system › Incorrect use/operation
  • factor Personnel issues › Task performance › Use of equip/info › Use of equip/system › Pilot
  • Environmental issues › Conditions/weather/phenomena › Wind › Gusts › Effect on equipment

Dual student

  • Certificate: student
  • Flight time: 71.3 hours in all; 71.3 in this make and model; 64.8 in the last 90 days; 24.8 in the last 30 days; 5.3 as pilot in command
  • Medical certificate: Class 1 (without waivers/limitations)
  • Seat: left
  • Injury: no injuries

The aircraft

  • Airframe total time: 475.6 hours
  • Last inspection: 100-hour inspection, April 15, 2016
  • Maximum gross weight: 2,550 lb
  • Seats: 4
  • Landing gear: fixed
  • Engine: Lycoming O-360-A4M (piston); 549 hours total
  • Operator: Atp USA, INC.

The flight

  • Departed from: CGC Crystal River FL at 5:50 pm
  • Destination: CGC Crystal River FL
  • Flight plan: none
  • Runway 27, 4,557 ft by 75 ft

Weather at the time

  • Light: daylight
  • Wind: from 280° at 6 knots, gusting 14
  • Visibility: 10 statute miles
  • Sky: clear
  • Temperature: 86°F (30°C), dew point 64°F (18°C)
  • Altimeter: 30.03 inHg
  • Observation at 5:55 pm from KCGC

Injuries

FatalSeriousMinorNone
Flight crew1

Documents from the investigation the NTSB's docket: the evidence folder behind the report

4 documents, released by the NTSB on July 20, 2016. View them here, or download them; the NTSB redacts some personal details before release, and this site shows the NTSB's own titles rather than its file names.

The same docket at the NTSB · documents without a copy here are fetched from the NTSB when you open them.

Everything on this page comes from the NTSB's public records. The narrative, probable cause and findings are the NTSB's own words; the coded tables behind the report are written out in plain English, with pilots' ages, home towns and medical details left out. The documents and photographs are the NTSB's docket, shown as the NTSB released them. This site's own text never names anyone involved. A preliminary report can change; the final report usually follows one to two years later, and the page is refreshed when it does.