Aviation Accident Summaries

Aviation Accident Summary LAX08FA002

Oak Hills, CA, USA

Aircraft #1

N6549W

PIPER PA-28-140

Analysis

During cruise flight in dark night conditions, the pilot stated to air traffic control that he was at 3,700 feet over the freeway interchange at the base of a mountain pass. The pilot transmitted to the controller that he could not climb because he had clouds above him that he could not climb through. The accident site was at the summit of the pass at an approximate elevation of 4,196 feet. A deputy sheriff was traversing the pass in the area of the accident site just prior to the accident and he noted heavy fog and very limited visibility at the top of the pass. As he proceeded down the hill, the visibility improved as he dropped below the clouds and he observed an airplane flying up toward the pass. Ground scars and impact signatures were consistent with controlled flight into terrain. Investigators found no anomalies with the airframe or engine that would have precluded normal operation.

Factual Information

HISTORY OF FLIGHT On October 5, 2007, about 0052 Pacific daylight time (PDT), a Piper PA-28-140, N6549W, collided with terrain during cruise flight near Oak Hills, California. The pilot was operating the airplane under the provisions of 14 Code of Federal Regulations (CFR) Part 91. The private pilot sustained fatal injuries. The airplane was substantially damaged. The personal cross-country flight departed Long Beach Airport - Daughtery Field (LGB), Long Beach, California, about 0012, with a planned destination of Henderson Executive Airport (HND), Las Vegas, Nevada. The flight was operating under visual flight rules (VFR), and no flight plan had been filed. The accident site was on mountainous terrain near the summit of the Cajon Pass. A deputy sheriff was transiting Cajon Pass just prior to the accident; he noted heavy fog and very limited visibility at the top of the pass at Oak Hills. As he proceeded down the hill on Interstate 15, the visibility improved as he dropped below the clouds. He observed an airplane flying up the pass toward Oak Hills. The Federal Aviation Administration (FAA) reported that the pilot had been in contact with Southern California Terminal Radar Approach Control (SCT). All times have been converted to PDT. A controller stated that the pilot contacted SCT 3 miles east of Long Beach at 0017, and requested VFR flight advisories to Henderson. The controller assigned a beacon code of 4753, and identified the airplane over Knotts Berry Farm. The pilot stated that he would maintain his present altitude until clear of clouds, and would then climb to 9,500 feet mean sea level (msl). The controller transferred the pilot to another controller on frequency 125.5. The pilot checked in with the new controller, and reported an altitude of 3,200 feet. The controller stated that he later noted that the pilot had not started a climb. He notified the pilot that he was headed toward higher terrain, and asked if the pilot could maintain his own terrain separation. The pilot responded that he could, and was starting a climb. The controller put the pilot in handoff status to Los Angeles Air Route Traffic Control Center Sector 20, and advised the pilot of lost radar contact. The pilot acknowledged that information. The pilot informed the controller that he was over the Interstate 15 and Interstate 215 interchange. This was the pilot's last communication with SCT. A review of recorded radio transmissions indicated that about 12 minutes elapsed from the initial contact with SCT until the pilot reported that he would start a climb. About 7 minutes later, SCT notified the pilot of lost radar contact. About another 7 minutes later, the pilot stated that he was at 3,700 feet. He said that he could not climb because he had clouds above him, and could not climb through them. He then stated his position over the interchange. The FAA supplied recorded radar data covering the area of the accident in the form of a National Track Analysis Program (NTAP) printout. The target with the beacon code of 4753 departed Long Beach to the west with a Mode C reported altitude of 200 feet mean sea level (msl) at 0012:44. The track continued to climb and made a right turn towards the northeast. During the proceeding 20 minutes, radar returns disclosed a gradual climb to a maximum altitude of 3,800 feet msl. For the last 16 minutes before radar contact was lost, the target's altitude fluctuated between 3,300 and 4,200 feet msl. About 0044:05, the track indicated a slight turn to the northwest, paralleling Interstate 215. In this area, the terrain elevation increased while approaching the Cajon Pass. The last target return was at 0048:50. The target was over the intersection of the Interstate 15 and 215 freeways with a reported altitude of 3,700 feet msl, and the terrain elevation about 2,400 feet. The radar plot stretched over a distance of approximately 61 nautical miles (nm) in 36 minutes 30 seconds. The last radar return was south of the accident location, approximately 7.3 nm from the accident site on a true course of 355 degrees. PERSONNEL INFORMATION A review of FAA airman records revealed that the 43-year-old pilot held a private pilot certificate with ratings for airplane single-engine land, single-engine sea, and instrument airplane. The pilot also held a third-class medical certificate issued on March 06, 2006. It had no limitations or waivers. An examination of the pilot's logbook indicated an estimated total flight time of 690 hours with 617 hours as pilot-in-command. The pilot logged 3 hours in the last 90 days, and 3 hours in the last 30 days. A biennial flight review was completed on September 15, 2007. Approximately 425 hours had been accumulated in the make and model airplane that was involved in the accident. The Certified Flight Instructor (CFI) that conducted the flight review stated that the ground portion covered a review of airspace, FAA regulations, aeronautical decision-making, and situational awareness concepts. The flight included stalls, steep turns, slow flight, emergency procedures, takeoffs, and landings. The CFI also noted he was impressed with the pilot's knowledge and skill level. Further examination of the pilot's logbook revealed that he completed instrument currency requirements on May 20, 2006. According to 14 CFR Part 61.57, a pilot must complete the requirements every 6 months to act as pilot-in-command (PIC) in instrument flight rule (IFR) conditions. On June 12 and 24, 2006, the pilot logged IFR flights where he was in IFR conditions for 0.5 and 3.6 hours, respectively. On November 24, 2006, the pilot logged two practice approaches. According to information in the pilot's logbook, his IFR currency would have expired on November 20, 2006. AIRCRAFT INFORMATION A review of the airframe logbook indicated that the airplane was a Piper PA-28-140, serial number 28-20628. It was manufactured in 1964, and had accumulated a total time of 7,920 hours. The last annual inspection was completed on October 23, 2006, 143 hours before the accident. A logbook entry dated January 16, 2006, indicated that the pitot/static system, altimeter, and transponder were inspected and tested. The engine was a Textron Lycoming O-320-E2A, serial number L-14765-27A. An engine log was not recovered. WRECKAGE AND IMPACT INFORMATION On site examination of the wreckage indentified the first identified point of contact (FIPC) was a ground scar consisting of three marks approximately 5 feet apart. The FIPC was about 389 feet from the main wreckage. The debris path was along a magnetic heading of 335 degrees. Investigators found both red and green lens fragments between the FIPC and the main wreckage. The red fragments were on the left side of the debris path starting about 10 feet from the FIPC, and the green were on the right side. The main wreckage was located at an approximate elevation of 4,196 feet msl. The airplane's cabin was orientated on a magnetic bearing of 155 degrees. The right wing and tail section remained attached to the fuselage. The left wing was attached to the airframe by a single flight control cable, and was inverted lying adjacent to the fuselage. All control surfaces were accounted for at the accident site. The left wing tip separated, and was about 96 feet to the north of the main wreckage. The left landing gear was also to the north, and downhill from the main wreckage. The propeller, a Sensenich 74DM6-0-58, serial number K30362, separated from the engine. It was about 113 feet south from the main wreckage. Both blades exhibited leading edge damage, chordwise striations, and trailing edge s-bends. The engine remained attached to the fuselage. Examination of the fuel system indicated no fuel in either the right or left tank. The left tank was punctured. The fuel pump was on, and the fuel selector valve was positioned for the right tank. MEDICAL AND PATHOLOGICAL INFORMATION The San Bernardino County Coroner completed an autopsy. The FAA Bioaeronautical Sciences Research Laboratory Forensic Toxicology Research Team, Oklahoma City, Oklahoma, performed toxicological testing of specimens of the pilot. Analysis of the specimens contained no findings for carbon monoxide, cyanide, volatiles, and tested drugs. TESTS AND RESEARCH Investigators from the airframe and engine manufacturer examined the wreckage under the supervision of the investigator-in-charge at Aircraft Recovery Service, Littlerock, California, on November 14, 2007. The engine was placed on a worktable. The Autolite UREM38E spark plugs were removed, and it was noted that they were clean with no mechanical deformation. The spark plug electrodes were gray, which corresponded to normal operation according to the Champion Aviation Check-A-Plug AV-27 Chart. The magnetos were manually rotated. Both magnetos produced spark on all terminals. The vacuum pump drive gear remained unbroken. All vacuum pump vanes were whole, in position, and moved freely. The oil sump screen was clean and open. The oil screen filter was clean. The engine was disassembled and visually inspected. The crankcase halves had no signs of fretting or cracks. The push rods had no signs of warping. The number two cylinder’s intake tappet body exhibited slight spawling. All four cylinders and pistons were similar in color and wear. The piston rings exhibited similar wear, and moved freely. The number three cylinder barrel head was cracked near the spark plug, leading to the exhaust valve port. The control column assembly was broken, which separated the control wheel from the flight controls. Flight control continuity was established for the aileron, rudder and elevator controls. The elevator trim had with four threads exposed; the neutral trim position is five threads.

Probable Cause and Findings

The pilot's continued flight into instrument meteorological conditions and failure to maintain terrain clearance during cruise flight. Contributing to the accident were mountainous terrain, dark night, and fog.

 

Source: NTSB Aviation Accident Database

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