NTSB CAROL · Event
Event LAX92FA064
Aircraft involved
Probable cause & findings
THE FAILURE OF THE PILOT TO PERFORM PREVENTATIVE MAINTENANCE ON THE AIRPLANE'S POWERPLANT WHICH RESULTED IN A LOSS OF PERFORMANCE DURING AN UNKNOWN PHASE OF OPERATION. CONTRIBUTING TO THE ACCIDENT WAS FOULED SPARK PLUGS AND THE PARTIAL LOSS OF AIRCRAFT PERFORMANCE.
Factual narrative
THE AIRPLANE COLLIDED WITH RUGGED TERRAIN AFTER A LOSS OF ENGINE POWER. IT STRUCK THE NORTH FACE OF 20 DEG SLOPE OF AN EAST-WEST RIDGE, JUST BELOW THE CREST. THE AIRPLANE THEN SLID ABOUT 20 FT DOWN THE SLOPE WHERE A POST-IMPACT FIRE DESTROYED THE PLANE. AN EXAM OF THE ENGINE SPARK PLUGS REVEALED THE #1 & #3 CYLINDER SPARK PLUG GAPS WERE BRIDGED WITH CINDER-LIKE DEPOSITS WITH METALLIC GLOBULES STARTING TO FILL THE FIRING END CAVITY & WORN CENTER ELECTRODES. ACCORDING TO THE SPARK PLUG MANUFACTURER, SEVERELY FOULED PLUGS WILL OPERATE COLDER CAUSING MISFIRES, AND WILL ALSO MISFIRE AT HIGHER POWER BECAUSE OF THE CONDUCTIVE NATURE OF THE DEPOSITS AT ELEVATED TEMPS. BRIDGED GAPS WILL SHORT OUT THE SPARK PLUG. SUCH A MALFUNCTIONED PLUG WILL MISFIRE AT ALL POWER SETTINGS IN A MANNER SIMILAR TO A OIL FOULED PLUG. BRIDGED GAPS BRIDGED BY BEADED LEAD GLOBULE WILL NOT CLEAR UP BY ENGINE OPERATION & CAN BE CORRECTED ONLY BY REPLACING THE MALFUNCTIONING SPARK PLUG WITH A SERVICEABLE UNIT. THE ACDNT TIME WAS ESTD BE AT 1530 PST. Source: NTSB Aviation Accident Database (Pre-2008 Archive) Retrieved: 2026-02-12
Verbatim from NTSB's published report. Source file
NTSB_1991_LAX92FA064.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 (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 ↗