Aviation Accident Summaries

Aviation Accident Summary ERA14FA027

Nashville, TN, USA

Aircraft #1




The noninstrument-rated pilot rented the airplane in Canada and filed a visual flight rules flight plan for a cross-country flight to a destination in Canada; the flight had not been approved to leave Canada. The flight plan was subsequently closed; the investigation could not determine the flight's last departure point and time. The airplane wreckage was found on an airport runway in Nashville, Tennessee, the following afternoon during an airfield inspection. Postaccident examination of the airplane found no mechanical malfunctions or failures that would have precluded normal operation. A review of airport radar data indicated that the airplane entered the Nashville area at night almost 9 hours after its initial departure time and that the airplane circled the airport for about 2 hours before it crashed on the approach end of the runway. Instrument flight rules (IFR) conditions, which included horizontal visibility of 1/4 statute mile and vertical visibility of 100 ft above ground level, existed about the time of the airplane's arrival until it crashed. A review of the pilot's health records, which included a mental health report provided by the pilot's parole officer, revealed that he had a history of repeated convictions for criminal activity and that he had developed a significant interest in a celebrity who lived in Nashville. Although the medical records did not include a specific psychiatric diagnosis, the pilot's prior criminal actions and impulsive behavior are consistent with antisocial personality disorder, which likely led to his impetuous decision to fly to Nashville. It is likely that, because of his impetuous decision, the pilot was unware of the IFR conditions in Nashville until he arrived in the area and that, because he was not instrument rated, he was unable to safely land the airplane with no visual contact with the runway. Toxicological testing of the pilot's blood revealed significantly elevated levels of ethanol, indicating that the pilot ingested alcohol before the accident. The alcohol likely further impaired the pilot's judgment and his ability to fly the airplane safely in IFR conditions.

Factual Information

HISTORY OF FLIGHT On October 29, 2013, about 0350 central daylight time (CDT), a Cessna 172R, Canadian registration C-GRJH, owned by the Windsor Flying Club and operated by a private individual, was destroyed by a postcrash fire when it impacted the runway during a landing attempt at Nashville International Airport (BNA), Nashville, Tennessee. The private pilot was fatally injured. Instrument meteorological conditions prevailed at the time of the accident. The last departure point of the flight was not determined. The personal flight was conducted under the provisions of Canadian Air Regulations. According to the Canadian flying club which owned the airplane, the pilot rented the airplane at Windsor Airport, Windsor, Canada on the afternoon of October 28, 2013. The pilot reported his destination as Pelee Island Airport, Pelee, Ontario. The flight departed Windsor Airport about 1800 after the pilot filed a visual flight rules flight plan. Transportation Canada reported the pilot closed his VFR flight plan about 2030. The pilot did not file any additional flight plans and a review of air traffic control information in Canada and the United States revealed no communication between air traffic control and the pilot. It could not be determined where the flight last departed and at what time. Airport operations at BNA conducted an airfield inspection on October 29, 2013, about 0200. No airplane wreckage was observed on runway 2C. At about 0845, an airplane taxing for departure reported a piece of airplane wreckage on runway 2C. Airport operations subsequently responded and discovered the wreckage about 0900. A review of BNA primary radar showed an airplane that arrived within the 20 nautical mile ring of BNA Class B airspace area about 0142. According to the primary radar returns, the airplane initially flew in circles near the outer northwest ring of Class B airspace before proceeding to the airport. About 0200 the airplane was observed flying in circles above runways 2L and 2C for about 5 minutes. The airplane traveled northwest again and momentarily circled a lighted tower before it returned to the airport and circled the airport for an additional 90 minutes. At 0350 the airplane was observed over the approach end of runway 2C, but did not reappear beyond the threshold. PERSONNEL INFORMATION The pilot, age 45, held a Canadian-issued private pilot certificate with ratings for single and multi-engine land. He was issued a valid third-class medical certificate on July 28, 2013. The pilot also held a Canadian radio telephone operator's certificate with qualifications for aeronautical use that was issued on January 8, 1990. The pilot's logbook could not be located and his flight time could not be verified; however, he reported to Windsor Flying Club that he had over 100 hours of flight experience. According to the club's records, the pilot's last biennial currency flight was on October 31, 2012. The pilot accumulated about 5.6 total hours of flight time in the accident airplane in the12 months prior to the accident. AIRCRAFT INFORMATION According to the Canadian Civil Aircraft Register, the accident airplane was a Cessna 172R, serial number 17280765, and was manufactured in 1999. It was powered by a Lycoming model IO-360-L2A engine, serial number L-18784-51A. The engine was rated at 160 horsepower at 2,400 rpm. The airplane was equipped with two wing fuel tanks that each held 26.5 gallons of usable 100 low lead aviation fuel. The airplane operator reported that the airplane was equipped for instrument flight under Canadian Aviation Regulations 605.18. According to airplane records, an annual inspection was performed on the airframe and engine on September 10, 2013, at 6,045 hours total time. The airplane total time could not be determined because the Hobbs meter was burned beyond recognition. METEOROLOGICAL INFORMATION Weather, recorded at BNA at 0153, included wind calm, one quarter statute mile visibility, runway 02L visual range between 1,200 feet and 1,400 feet, fog, vertical visibility 100 feet above ground level (agl), temperature 12 degrees C, dewpoint 11 degrees C, and an altimeter setting of 30.28 inches Hg. Weather, recorded at BNA at 0234, included wind calm, less than one quarter statute mile visibility, runway 02L visual range 600 feet, fog, vertical visibility 100 feet agl, temperature 12 degrees C, dewpoint 12 degrees C, and an altimeter setting of 30.27 inches Hg. Weather, recorded at BNA at 0253, included wind calm, less than one quarter statute mile visibility, runway 02L visual range 600 feet, fog, vertical visibility 100 feet agl, temperature 12 degrees C, dewpoint 12 degrees C, and an altimeter setting of 30.27 inches Hg. The following ceilings and visibilities were reported at BNA around the time of the accident. All runway visual range (RVR) values were for runway 02L. At 0353, one quarter statute mile visibility and a vertical visibility of 100 feet agl were reported. At 0453, one quarter statute mile visibility with an RVR from 800 feet and 1,200 feet, and a 100 foot vertical visibility were reported. At 0553, one quarter statute mile visibility with RVR from 800 feet and 1,000 feet and a vertical visibility of 100 feet were reported. At 0653, one quarter statute mile visibility with an RVR from 1,200 feet and 1,400 feet, and a vertical visibility of 100 feet were reported. At 0753, one eighth statute mile visibility, with an RVR from 1,000 feet and 1,600 feet, and a vertical visibility of 100 feet were reported. At 0853, one eighth statute mile visibility, with an RVR from 700 feet and 1,000 feet, and a vertical visibility of 100 feet were reported. The National Weather Service reported an area forecast for Tennessee prior to the accident with ceilings below 1,000 feet and visibility below 3 statute miles, mist, and fog from October 28, 2013 at 2100 to October 29, 2013 at 0400. AIRPORT INFORMATION Nashville International Airport was a tower-controlled, public-use airport equipped with four concrete runways oriented in a 13/31, 2R/20C, 2L/20L, and 2C/20C configuration. According to FAA records, runway 2C was 8,001 feet long and 150 feet wide, with high intensity runway edge lights and 1,400 foot medium intensity approach lights accompanied by runway alignment indicator lights. The runway field elevation was 569.1 feet. WRECKAGE AND IMPACT INFORMATION The airplane wreckage came to rest about 468 feet from the runway 2C threshold at BNA and was consumed by fire. The wreckage path was about 695 feet in length and oriented on a heading of about 040 degrees magnetic. The path was marked by two gouges that resembled propeller slash marks located about 200 feet from the runway threshold. A fire signature was noted by heavy soot marks that began 220 feet after the initial impact point and continued to the main wreckage. The engine was also located in the energy path about 150 feet past the main wreckage. Both the propeller and crankshaft flange were separated from the engine and located about 120 feet to the right of the wreckage path and 200 feet from the initial impact point. Both propeller blades exhibited bending opposite the direction of rotation, torsional twisting, leading edge abrasions and chord-wise scoring. Blade A, arbitrarily designated by investigators, exhibited heavy leading edge gouging and the eight inches of the blade tip were impact separated. The blade tip to Blade B was curled about 360 degrees. Aileron control cable continuity was confirmed from the flight control surfaces to the cockpit controls. The rudder, elevator, and elevator trim cables were intact and control cable continuity was confirmed from the flight control surfaces to the empennage, which remained attached to the fuselage by cables. The elevator trim actuator measurement was 1.25", which corresponded to a 0 degree trim tab deflection. Flap control continuity was traced from the flaps to the flap actuator which was in the flaps retracted position. The airplane sustained major fire damage to the fuselage, cockpit and engine compartments. Examination of the cockpit revealed no discernable instruments or retrievable data. The postcrash fire also consumed most of the fuel system. The engine was partially disassembled at the accident site under the supervision of the NTSB Investigator. Continuity of the crankshaft was confirmed to the rear gears and the valve train when it was rotated through the vacuum pump drive and internal engine continuity was confirmed to most of the accessory drives. The cylinders were examined using a lighted borescope and no anomalies were noted. The top spark plugs and vacuum pump were removed from the engine and valve movement, thumb compression, and suction were observed at each of the four cylinders. The upper spark plug electrodes were normal in color and wear; the bottom spark plugs were impact damaged or obstructed by the crushed exhaust tubes. The upper vacuum pump remained attached to the engine and its drive coupling, carbon rotor and carbon vanes were all intact. The lower pump was impact separated and the carbon rotor was fractured; however, the carbon vanes remained intact. Both magnetos were found at the accident site; the left magneto was partially separated from the engine and could not be operated by hand. The right magneto had separated from the engine and produced spark at all leads when rotated by hand. MEDICAL AND PATHOLOGICAL INFORMATION An autopsy was performed on the pilot by the Tennessee Department of Health, Nashville, Tennessee, on October 29, 2013. The cause of death was listed as "multiple blunt force and thermal injuries." The blood carboxyhemoglobin concentration was 1.3% and not indicative of smoke inhalation during a fire. Toxicological testing was conducted by the State of Tennessee by NMS laboratories, which detected ethanol in the chest blood at 0.081 grams/deciliter (g/dL) and vitreous at 0.120 g/dL. Further toxicological testing performed by the FAA's Bioaeronautical Sciences Research Laboratory, Oklahoma City, Oklahoma detected ethanol in samples of muscle (0.098 g/dL), lung (0.082 g/dL), heart (0.076 g/dL), cavity blood (0.064 g/dL), liver (0.055 g/dL) and brain tissue (0.043 g/dL). Federal Aviation Regulations prohibit operation of aircraft with a blood alcohol/ethanol level greater than 0.040 gm/dL. Toxicological testing found no evidence of putrefaction. The NTSB Medical Officer reviewed the FAA Medical Case Review, toxicology results, autopsy report and health records that included a statement and mental health report provided by the pilot's parole officer. The pilot's Canadian medical records were not available for review. The parole report indicated a history of repeated convictions for criminal activity. During the pilot's mental health evaluation in August 2012, he reported that he had developed a significant interest in a celebrity and had written several letters to her. According to the mental health evaluator, the letters "have the flavor of stalking." The celebrity of interest resided in Nashville, Tennessee at the time of the accident.

Probable Cause and Findings

The noninstrument-rated pilot’s continued visual flight into night instrument flight rules conditions, which resulted in a collision with the runway during an attempted approach to land. Contributing to the accident was the pilot’s mental state, his impairment due to alcohol, and his decision to operate the airplane from Canada to the United States without the owner’s permission and without proper clearances for the flight.


Source: NTSB Aviation Accident Database

Get all the details on your iPhone or iPad with:

Aviation Accidents App

In-Depth Access to Aviation Accident Reports