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Decision to continue instrument approach injures four

By NTSB · December 14, 2015 ·

The Cessna 182 pilot reported that during an instrument landing system (ILS) approach in instrument meteorological conditions, she descended into fog about 1,000 feet above ground level near Hillsboro, Ore.

She continued the approach beyond the minimum descent altitude and stated that she did not see the runway or runway environment until she was beyond the 1,000-foot runway markings, and realized the airplane had drifted right of the runway.

She attempted to maneuver the plane towards the runway, however it landed hard in a grassy, mud-covered area, off the right side of the runway, resulting in four minor injuries.

A post-accident examination revealed the fuselage was structurally damaged.

The NTSB determined the probable cause as the pilot’s decision to continue the instrument approach beyond the published missed approach point.

NTSB Identification: WPR14CA077

This December 2013 accident report is provided by the National Transportation Safety Board. Published as an educational tool, it is intended to help pilots learn from the misfortunes of others.

About NTSB

The National Transportation Safety Board is an independent federal agency charged by Congress with investigating every civil aviation accident in the United States and significant events in the other modes of transportation, including railroad, transit, highway, marine, pipeline, and commercial space. It determines the probable causes of accidents and issues safety recommendations aimed at preventing future occurrences.

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Comments

  1. drew says

    December 15, 2015 at 7:04 am

    probably the best decision given the circumstances
    tough airplane
    slow stall speed
    near airport
    good call

  2. Mike says

    December 15, 2015 at 5:53 am

    They call it minimum descent altitude and missed approach point for a reason.

    • Mike Magnell says

      December 15, 2015 at 9:19 am

      On an ILS the minimum descent altitude is called the decision height (DH). It is not stated here how far below DH she went nor did it state what the DH was or what the actual weather was. A standard ILS approach is 200 DH and a half mile visibility. The visibility must be 1/2 mile or more for a commercial airline operator to legally begin the approach, however, a private FAR part 91 operator can attempt the approach no matter how low the weather is. So in order to get the full picture of exactly what went on here we need all of the missing information. Apparently she/pilot did state that she did not see the runway environment at DH (200ft) and she kept desending anyway. That put her in direct violation of the FARs no gray area there. Two hundred feet above the ground on a Category 1 approach is pretty low and trying to go lower without the runway environment in sight is not only not legal, but it gets dicey real quick with no room for error if you are not exactly lined up on the localizer with the needle centered. Scarey.

      • Paul says

        December 15, 2015 at 5:23 pm

        “The visibility must be 1/2 mile or more for a commercial airline operator to legally begin the approach.”

        That applies only to Cat 1. If a PAR approach is available that can be used to provide course, glidepath and trend information all the way to touchdown as well as a recommended go around from the controller if deviations from the course and glidepath are considered unsafe for landing. Radar monitoring of an ILS approach with advisories can also be requested if it is available. I have had experience landing in zero-zero conditions using a PAR and hands on flying (not coupled). Upon reaching DH the controller will continue with course and glidepath calls all the way to touchdown. ALSR lighting and centerline lighting (particularly the latter) is a must when below CAT 1 minimums. Running rabbit lighting (sequencing flashers) on approach can be distracting in foggy conditions. Landing lights and/or anti-collision/strobe lights are typically not used in such conditions because of the reflected light distraction.

        • Michael Magnell says

          February 10, 2016 at 8:28 am

          A PAR approach is primarily a military approach. While available at some civilian airports many civilians pilots do not have experience with them. I have done a few but not near enough to be as skilled doing one as I am at flying an ILS. PARs are controller intense and tremendously increase the controllers work load so these approaches are not viable at any busy airports. Keep in mind we were talking about a Category I ILS approach.

          It all boils down to the fact that if you want to be a safe instrument pilot; stay current and do not go below minimums on ANY approach. If any airline crew is caught going below minimums on any approach they will be immediately terminated by their airline! And since there are always two pilots in the cockpit of an airliner, do you really they think one of them would ever try and go below minimums. INSANE!

      • John says

        December 15, 2015 at 7:41 pm

        The pilot’s report of accident says she was told by Portland Approach that the prior aircraft was unable to land and executed a missed approach. She then asked for the approach. When she busted DH and crashed her recommendation for others to avoid a similar fate was for the controller to refuse to issue a clearance. She obviously did not know who was Pilot In Command! The position of Controller In Command is not yet recognized by the FAA, NTSB, or taught in any aviation ground school I’ve ever heard of. FWIW, here previous flight was logged two months prior to the accident. The accident was in weather to minimums at night. Perhaps her decison making skills were rusty too.

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