NTSB CAROL · Event
Event CEN18LA084
Aircraft involved
Probable cause & findings
Maintenance personnel’s improper maintenance of the engine, which resulted in a catastrophic engine failure due the shifting/slipping of the No. 2 bearing and the subsequent oil starvation and total loss of engine power during cruise flight.
Factual narrative
On January 22, 2018, at 0845 central standard time, a Beech A36, N3600A experienced a total loss of engine power during climb after departing from Abilene Regional Airport (ABI), Abilene, Texas. The private pilot then performed a forced landing to a field near Abilene, Texas. The pilot sustained serious injuries and the airplane sustained minor damage. The airplane was registered to and operated by the pilot under Title 14 Code of Federal Regulations Part 91 as a personal flight that was operating on a visual flight rules flight plan. Day visual meteorological conditions prevailed at the time of the accident. The flight originated from ABI at 0835 and was destined to Sierra Blanca Regional Airport (SRR), Ruidoso, New Mexico. The pilot stated that upon level off at cruise altitude, there was a "severe vibration" from the engine compartment followed by a sound of the engine "coming apart." Oil covered the windshield and the smoke entered the cockpit. The pilot stated that he was unable to return to ABI due to its distance from his position and attempted a forced landing to Dyess Air Force Base (AFB), Texas. The pilot was unable to attain Dyess AFB due to the airplane's altitude. The pilot performed a forced landing to a field about one mile southwest of Dyess AFB with the landing gear and flaps retracted. Post-accident examination revealed the engine was intact with all the accessories attached. A large hole was observed in the left crankcase half over the number two-cylinder attachment point, and a small hole was observed in the right crankcase half over the number five-cylinder attachment point. Cylinders two, four, and six were Continental cylinders and had chrome markings. Cylinders one, three, and five were ECI cylinders. The number 2 main bearing shifted in the bearing saddle, which cut off the oil supply to the number 2 rod cap bearing. The number 2 connecting rod separated from the connecting rod journal on the crankshaft. The number 2 rod journal on the crankshaft was very dry and partly melted. The number 2 rod cap bearing was melted and most of it was found in the oil sump. The engine logbook had an entry dated January 23, 2015, at a tachometer time of 4,173 hours, for the removal and replacement of the number two cylinder. The most recent entry for disassembly of the engine, as part of an annual inspection, was dated February 12, 2016, at a tachometer time of 4,299.6 hours and 1,796.0 hours since overhaul. The entry states, "#4 and #6 cylinders were removed due to exhaust leaks." The mechanic who performed the annual inspection dated February 12, 2016 performed the most recent annual dated February 9, 2017, at a tachometer time of 4,442.7 hours. The tachometer indication at the time of the accident was 4,501.0 hours. The private pilot was conducting a cross-country, personal flight. He stated that, upon leveling off at cruise altitude, there was a "severe vibration" coming from the engine compartment, followed by a sound of the engine "coming apart." Oil covered the windshield, and the smoke entered the cockpit. The pilot was unable to return to the departure airport because it was beyond gliding distance, so he performed a forced landing on a field with the landing gear and flaps retracted. The pilot sustained serious injuries. Postaccident examination of the engine revealed a large hole in the left crankcase half over the No. 2 cylinder attachment point and a small hole in the right crankcase half over the No. 5 cylinder attachment point. The No. 2 main bearing had shifted in the bearing saddle, which cut off the oil supply to the No. 2 rod cap bearing. Shifting/slipping of the bearing can result from either improper torque application during cylinder replacement or improper grinding of the bearing journal during maintenance. The engine had been disassembled twice before the accident. An engine logbook entry showed that the No. 2 cylinder had been removed and replaced about 328 hours before the accident. It is likely that maintenance personnel did not conduct proper maintenance on the No. 2 cylinder during reassembly of the engine and that this ultimately led to the catastrophic engine failure due the shifting/slipping of the No. 2 bearing and the subsequent oil starvation and total loss of engine power. Source: NTSB Aviation Accident Database Retrieved: 2026-02-12
NTSB Findings
Hierarchical cause / factor breakdown from the FAA bulk avdata database. Each finding tagged C (Cause) or F (Factor).
- C Personnel issues-Task performance-Maintenance-Repair-Maintenance personnel - C
- C Aircraft-Aircraft power plant-Engine (reciprocating)-(general)-Failure - C
- C Aircraft-Fluids/misc hardware-Fluids-Oil-Not specified - C
- C Aircraft-Aircraft handling/service-Maintenance/inspections-Scheduled maint checks-Incorrect service/maintenance - C
Verbatim from NTSB's published report. Source file
NTSB_2018_CEN18LA084.txt.
Findings + structured fields enriched from FAA avall.mdb.
Full investigation docket on
data.ntsb.gov ↗.
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Related research
What the literature says.
Academic papers and agency reports matching this event's aircraft type or causal vocabulary (engine failure, maintenance). Sourced from NASA NTRS, NTSB Safety Studies, FAA CAMI, AOPA Air Safety Institute, Embry-Riddle Scholarly Commons, arXiv, and the Semantic Scholar academic graph.
- Embry-Riddle Scholarly Commons 2026 · Journal article (IJAAA)
From Reactive to Predictive: A hybrid Trust-Mediated Adoption Framework for Data-Driven Maintenance in Distributed-Authority Aviation Environments
Modern aviation maintenance operates within increasingly data-intensive technological environments, yet the operational integration of predictive maintenance into routine decision-making remains incon…
- Semantic Scholar 2025 · Article (Applied Sciences)
Decision-Making Framework for Aviation Safety in Predictive Maintenance Strategies
The implementation of predictive maintenance (PM) in aviation presents unique challenges due to strict safety requirements, complex operational environments, and regulatory constraints.
- Embry-Riddle Scholarly Commons 2024 · Journal article (JAAER)
Low-Resource Automatic Speech Recognition Domain Adaptation – A Case-Study in Aviation Maintenance
With timeliness and efficiency being critical in the aviation maintenance industry, the need has been growing for smart technological solutions that optimize and streamline the different underlying ta…
- Embry-Riddle Scholarly Commons 2024 · Journal article (JAAER)
A New Trajectory in UAV Safety: Leveraging Reinforcement Learning for Distance Maintenance Under Wind Variations
In the field of aviation, safety is a critical cornerstone, and the operation of Unmanned Aerial Vehicle (UAV) systems is deeply connected with this principle.
- Embry-Riddle Scholarly Commons 2024 · Journal article (IJAAA)
Just Culture in Aviation: A Metaphorical Study on Aircraft Maintenance Students
Just Culture, a sub-dimension of safety culture, has been a prominent and debated topic in aviation safety in recent years.
- Embry-Riddle Scholarly Commons 2024 · Journal article (IJAAA)
Performance PRISM: A Comprehensive Framework For Performance Measurement In Aircraft Maintenance
Aircraft maintenance is governed by rigorous safety requirements and high operational complexity, demanding robust performance measurement frameworks to ensure optimal maintenance practices.
Browse the full corpus — academia portal ↗