On December 8, 2018, at 1314 eastern standard time, a Cessna P210, N731LT, sustained substantial damage when it was involved in an accident near Myerstown, Pennsylvania. The private pilot was seriously injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. The pilot reported that he was flying to a nearby airport to refuel the airplane. He stated that he checked the fuel using the onboard fuel totalizer, and both fuel gauges indicated that there was enough fuel for the intended flight. During the approach, the engine lost total power on the downwind leg of the airport traffic pattern. The pilot reported that the loss of engine power was due to fuel starvation. The pilot also reported that he should have used a fuel tank dip stick to confirm the amount of fuel onboard. According to a witness at the airport, as the airplane approached the airport, it made a "very sharp left-banking turn" as it flew over. The airplane then climbed steeply and made another sharp left turn to enter the left downwind for runway 19. He watched as the airplane continued the downwind leg, then made another sharp left turn to final. The airplane then turned to final and appeared to "stall" before impacting the ground. The airplane came to rest about one-half mile short of runway 19. A review of photographs provided by a Federal Aviation Administration inspector revealed substantial damage to both left and right outboard wing sections. The engine was partially attached to the firewall and remained within the engine mount. Before recovery from the site, less than 1 gallon of fuel was drained from the left-wing tanks and less than 4 gallons of fuel was drained from the right-wing tanks. The fuel was examined for contamination, and none was found. Examination of the fuel system revealed no evidence of fuel in the engine-driven fuel pump filter, and the filter was clean. There was no evidence of fuel in the lines between the engine-driven pump and engine gas producer. The pilot’s operating handbook for the airplane contained the note: Unusable fuel is at a minimum due to the design of the fuel system. However, when the fuel tanks are 1/4 full or less, prolonged uncoordinated flight such as slips or skids can uncover the fuel tank outlets, causing fuel starvation and engine stoppage. Therefore, with low fuel reserves, do not allow the airplane to remain in uncoordinated flight for periods in excess of one minute.