Aviation Accident Summaries

Aviation Accident Summary ERA09FA215

Lexington, KY, USA

Aircraft #1

N4871N

CESSNA 182Q

Analysis

Shortly after takeoff, and while operating in instrument meteorological conditions on an instrument-rules flight plan, the pilot contacted air traffic control (ATC). The pilot advised the ATC controller that his "engine was fine, but that his battery was draining" and that he may "lose radio communication." Shortly afterwards, the airplane began to deviate from its assigned course and heading until radio communications and radar contact were lost. A witness in the area of the accident stated that the airplane "flew over his home and made two circles in approximately 30 seconds." The witness added that "the airplane sounded very close, and the engine sounded normal," before he heard the airplane impact the ground. Examination of the wreckage did not reveal any preimpact failures or malfunctions. Toxicological testing of tissue specimens from the pilot detected butalbital, (a prescription barbiturate typically used for severe headaches) bupropion, a prescription antidepressant also used for smoking cessation, and ethanol. The butalbital detected was consistent with use within 24 hours before the accident, and studies have shown butalbital can impair a pilot's ability to fly; however, the actual level of butabital in the pilot's system could not be determined because of the lack of fluids. It was not possible to estimate from the toxicology when the bupropion might last have been used, but this medication has been associated with an increased seizure risk. No fluids were available for analysis, so it could not be established whether the ethanol found was from ingestion. The pilot, a physician, had a history (known to the Federal Aviation Administration) of alcohol abuse, but the pilot did not note the use of any medications or any medical conditions on his most recent Application for Airman Medical Certificate. The role of the pilot’s medications, possible medical conditions, or possible alcohol ingestion in the accident could not be determined.

Factual Information

HISTORY OF FLIGHT On March 25, 2009, about 2159 eastern daylight time, a Cessna 182Q, N4871N, crashed into a wooded area 3 miles west of Blue Grass Airport (LEX), Lexington, Kentucky. The private pilot was killed, and the airplane was substantially damaged. Instrument meteorological conditions prevailed at the time of the accident, and an instrument flight rules flight plan was filed. The airplane was owned and operated by 4871N Incorporated, under the provisions of 14 Code of Federal Regulations Part 91. The flight departed Bowling Green-Warren County Regional Airport (BWG), Bowling Green, Kentucky, at 2117. Shortly after takeoff from BWG, the pilot contacted the Indianapolis Air Route Traffic Control Center (ARTCC). The ARTCC controller reported having difficulty communicating with the pilot because of poor radio reception. At 2126, the pilot told the ARTCC controller that he had a low voltage indication and that his "battery was draining down." The controller asked the pilot about the condition of his engine, and the pilot responded that his "engine was fine, but that his battery was draining" and that he may "lose radio communication." He said that if he lost communications or the instruments, he had an externally powered GPS, and back up communication transmitter. At 2147, the ARTCC controller identified the airplane at 37 nautical miles southwest of LEX, at 2,900 feet. The ARTCC controller stated that the pilot’s altitude and course heading were fluctuating, although he continued to give him headings and altitude corrections. The controller asked if the pilot wanted to declare an emergency, and if he needed equipment standing by. The pilot responded that he had broken out of the clouds, but was losing sight of the ground. The controller contacted the pilot to verify that he was not declaring an emergency. The pilot responded that he was not declaring an emergency, and that he did not need any equipment on standby, he just "needed help getting in." The ARTCC controller asked the pilot if he could maintain altitude and heading, and the pilot responded "affirmative." The pilot continued to descend and climb. Shortly thereafter, the controller advised the pilot that he was in a descending left turn. At 2159, ARTCC lost radar and radio communications with the airplane. A witness in the area of the accident stated that the airplane "flew over his home and made two circles in approximately 30 seconds." The witness continued by saying that "the airplane sounded very close, and the engine sounded normal." The witness then heard the airplane hit the ground. He went outside, and located the downed airplane behind his home. PERSONNEL INFORMATION The pilot, age 57, held a private pilot certificate for airplane single engine land, and instrument airplane. His certificate was issued on December 14, 1993. He held a third-class medical certificate issued on February 12, 2008, with waivers for corrective lenses. Review of the pilot's logbook indicated that he had accumulated 1,693.1 total flight hours, and 380 flight hours of actual instrument time. AIRCRAFT INFORMATION The airplane was manufactured in 1980 as a four-seat, high-wing airplane with fixed tricycle landing gear and powered by a Continental O-470-U (17), 230-horsepower engine. Review of the aircraft logbook revealed that an annual inspection was conducted on the engine on August 9, 2008, at a tachometer time of 1,819.3 hours, and a total time of 3,768.1 hours. The current Hobbs time indicated 3,900.1 hours. METEORLOGICAL INFORMATION The reported weather at LEX, located about 3 miles west of the accident site, at 2154 was: winds 190 degrees at 7 knots, visibility 8 miles and rain, 500 feet broken, overcast 1,400 feet, temperature 14 degrees Celsius (C), dew point 12 degrees C, and altimeter setting of 29.92 inches of mercury. WRECKAGE AND IMPACT INFORMATION Examination of the accident site revealed that the aircraft impacted the ground on a 260 degree magnetic heading. The initial ground impact scar was approximately 1 foot deep and 8 feet long. The wreckage debris path, from the initial ground scar to the final resting place of the wreckage, was approximately 54 yards. The airframe was substantially damaged by impact with the terrain, and fragmented along the wreckage path. All flight control surfaces were located at the wreckage site and were damaged from impact. All flight control cable separation points were consistent with tension overload. The smell of 100LL fuel was evident throughout the site. Both wings were breached and the fuel tank areas displayed signatures of hydraulic bulging at impact. Examination of the airframe and flight control system components revealed no evidence of preimpact mechanical malfunction. The air (vacuum) driven attitude indicator gyro was recovered and examined. The gyro and gyro housing exhibited evidence of rotation. The electric driven turn-and-bank gyro was recovered (without its housing, instrument body, or face card) and examined. The gyro alone exhibited evidence of rotation with secondary scratches. The electric driven direction gyro indicator was recovered and examined. The gyro and gyro housing exhibited evidence of rotation. Only the face plates of the airspeed and vertical speed indicators were found. Throughout the cabin section there were batteries and flashlights. Examination of the engine revealed heavy external impact damage. The engine was partially disassembled for examination. The top spark plugs were removed, and exhibited normal wear. The vacuum pump was still connected to the accessory housing, and was removed for examination. The vacuum pump coupling was intact, but the housing of the pump was impact damaged. The propeller assembly was separated from the crankshaft propeller attachment flange. The blade hub was fragmented and both blades were located along the wreckage path. Both blades exhibited leading edge tip gouge marks, and "S" bending. MEDICAL AND PATHOLOGICAL INFORMATION The Office of the Associate Chief Medical Examiner of the Commonwealth of Kentucky conducted the postmortem examination of the pilot, on March 27, 2009. The reported cause of death was blunt force trauma. Forensic toxicology was performed on specimens from the pilot by the Federal Aviation Administration Bioaeronautical Sciences Research Laboratory, Oklahoma City, Oklahoma. No blood, urine, or vitreous was available for analysis, and a notation on the toxicology report indicated “putrefaction: yes”. The toxicology report stated that 105 (mg/dL, mg/hg) of ethanol was detected in the muscle, and 40 (mg/dL), mg/hg) of ethanol was detected in the liver. Bupropion was detected in the liver and kidney. Bupropion metabolite was detected in liver and kidney. 1.367 (ug/ml, ug/g) Butalbital detected in liver, and 0.646 (ug/ml, ug/g) detected in the kidney. The pilot, a physician, had reported two DUI convictions to the FAA in the 10 years prior to the accident. The first reported DUI was on April 22, 2000; the pilot had not reported the blood alcohol concentration for this DUI to the FAA, but records obtained by the NTSB from the Kentucky State Police noted a blood alcohol concentration of 0.15% more than an hour after the pilot was stopped for speeding. The second reported DUI was on December 10, 2006, with a noted alcohol reading of 0.147% on a breath test (time not noted). The FAA sent the pilot Authorizations for Special Issuance of a Medical Certificate on June 4, 2007 and February 2, 2008 for a history of substance abuse, and a letter on January 30, 2009 establishing that he was eligible for a third-class medical certificate. The pilot did not note the use of any medications or any medical conditions on his most recent Application for Airman Medical Certificate dated February 25, 2008.

Probable Cause and Findings

The pilot's failure to maintain control of the airplane for undetermined reasons.

 

Source: NTSB Aviation Accident Database

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