The commercial pilot and three passengers departed on an instrument flight rules (IFR) flight in instrument meteorological conditions that included a ceiling of 200 feet agl.
About a mile from the departure end of the runway at the airport in Pottsville, Arkansas, the A36 hit a ridge that was 216 feet above the airport’s elevation.
All four people on board died in the crash.
Damage to the airplane and to the trees was consistent with controlled flight into terrain with the engine operating at a high power setting.
Performance calculations indicated that the plane had the capability to attain and maintain the minimum required IFR departure climb rate to safely clear terrain on takeoff from the departure runway.
Toxicology tests identified terazosin in the pilot’s blood, as well as pravastatin, ranitidine, terazosin, and salicylate in urine. However, these medications do not cause drowsiness or affect judgment or executive function and are not considered impairing.
Although the pilot had history of arrhythmia and his autopsy found one area of severe coronary artery disease, it is unlikely these medical conditions contributed to the accident.
Probable cause: The pilot’s failure to maintain a sufficient climb rate during departure in instrument meteorological conditions, which resulted in controlled flight into terrain.
NTSB Identification: CEN16FA024
This October 2015 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.
I have been flying for 40+ years I am commercial multi engine instrument rated I fly single-engine high-performanceand I just want to say that the weather conditions at the time of this flight would’ve been way below my personal minimums . I would’ve never taken off under those conditions!
Or, maybe he did everything right! He did get his wx briefings and it’s been stated numerous times he was very familiar with the airport and surrounding area and maybe something did happen to the engine! Two witnesses reported hearing the engine cutting out and sputtering. If you’re climbing in IFR conditions and you know the ridge is ahead of you and you lose power for whatever reason and you’re doing 120KIAS, that doesn’t leave you much time at all to figure it out and make a radio call to announce the emergency. Maybe he did everything right and it just didn’t work out. For some of you to make wild assumptions and blatant statements is inconsiderate and rude.
CFIT – https://en.wikipedia.org/wiki/Controlled_flight_into_terrain << one should read this definition.
Controlled Flight Into Terrain. The NTSB report stated:
"Damage to the airplane and to the trees at the accident site was consistent with controlled flight into terrain with the engine operating at a high power setting."
High power setting and damage to the trees indicate that the pilot was not experiencing an engine failure.
I read the whole NTSB report before I posted. In fact, I was the first person to post a comment on this article and I summarized a lesson to be learned:
"Note when one’s Instrument skills are deteriorating and STOP flying IFR." I should have added "hard" to that, because I also said that had he taken off in MVFR conditions, this crash probably would not have happened.
I agree generally with your point otherwise. Too many posts are by people who apparently did not read the NTSB report or otherwise assume facts NOT in evidence, making assertions that, well, they can't back up. And those arguments are otherwise moot — because we don't have a black box or a living witness to the events leading up to the CFIT.
I'm glad others who knew this pilot have posted exculpatory (?) information showing that the pilot did know this airport, having flown in and out of it many times within, what, 2 weeks?
Unfortunately, in this case, there is no black box to reference, because many of us would like to know what actually went wrong.
Good observation! I agree this could well explain this accident occurring in an area very familiar to this pilot.
The airport in question was Russellville, the “mountain” was near Pottsville, and this pilot had flown in and out many times, in fact several within the week or two prior to the accident ferrying this family to an ill relative in East Tennessee. This flight was to attend that relative’s funeral. Consequently, he was very familiar with the airport. I’ve landed at this airport many times and it’s difficult to understand how he hit the “mountain” that he hit? Of course it will never be known what the actual facts were that led to this accident.
I forgot to mention that Terazosin is used to treat enlarged prostates and hypertension by relaxing the blood vessels which can cause fainting or dizziness. In fact one of the warnings given to patients is to be careful if they plan to drive a car or operate any machinery requiring being fully alert. I’m not suggesting this was the cause, but is a possibility.
When someone takes of in hard IFR conditions and continues straight ahead into a ridge, apparently disregarding any sort of pre-flight planning, it is not an “accident”, it is gross negligence, and should be termed what it is, a crash.
The definition of accident is an undesirable or unintended event and I think this was exactly that.
Whatever the reason, gradual cognitive impairment or simple negligence, this pilot was in violation of 91.103. He apparently did not familiarize himself with all aspects of his intended flight, such any published instrument departure procedures, or the terrain around the airport. He apparently flew straight ahead into terrain that was above the elevation of, and in close proximity to, the departure airport. It is a shame that innocent passengers lost their lives, and general aviation again gets a black mark in the eyes of the general public. Didn’t the recent marginal evaluations throw up a red flag to someone that this pilot’s competency be further reviewed?
Assuming the airport was KRUE – Russelville Muni the pilot likely did not read or ignored the takeoff minimums.
RUSSELLVILLE, AR
RUSSELLVILLE REGIONAL (RUE)
TAKEOFF MINIMUMS AND (OBSTACLE)
DEPARTURE PROCEDURES
AMDT 1 16287 (FAA)
TAKEOFF MINIMUMS:
Rwy 7, 500 -2 or std. with a min. climb
of 490′ per NM to 900. Rwy 25, 1800 – 3 or std. with a min.
climb of 230′ per NM to 2200.
TAKEOFF OBSTACLE NOTES:
Rwy 7, bldg. 3192’ from
DER, 204’ left of center line,
50’ AGL/520’ MSL.
The NTSB accident docket provides additional information that is helpful in understanding this accident
The accident pilot was invited to leave a five day King Air sym course not long before the accident. The Sym instructor said his performance was consistently “below standards”.
Just four months prior to the accident the accident pilot was relieved of flying duties for a King Air where he flew as second-in-command from Feb 2015 to Jul 2015. The Mr Hartman, King Air pilot, offered the following assessment of the accident pilot’s performance:
• Mr. Hartman stated the pilot’s multi-tasking abilities and situational awareness were a weak area.
• During one episode, the accident pilot landed with the brakes engaged, which blew the main tires.
• On some takeoffs, the pilot did not ensure full power was being applied. Because his hand was not on the throttle lever, he did not notice if the lever was in the full forward position.
• The pilot tended to have instrument fixation issues, struggled to utilize the flight director properly, and sometimes did not reference the attitude indicator enough during critical phases of flight.
Another individual consulted during the investigation who had flown in a Part 135 with him described the pilot in entirely different terms. At that time, 30 years previous, the pilot was described as ‘capable’, ‘concientious’, ‘thorough’, and consistent.
These very different pictures of the pilot separated by many years suggest undiagnosed cognitive decline. Yes, that’s speculative. However the pilot’s documented performance problems in months prior to the accident which are at a striking contrast to his performance earlier in his career as described by former coworkers are commonly observed symtoms of decline.
I read the NTSB report. It looks like this guy’s flying skills were deteriorating. One thing that had been noted was he would get fixated on an instrument and not note altitude in high workload situations in a two pilot environment.
In this case we have a single pilot IFR operation where initial departure is a high workload situation, especially when one has to transition to instruments immediately upon take-off.
I believe that this pilot would have been just fine had he had personal limits that he would not depart in less than MVFR conditions.
Lesson to get from this: Note when one’s Instrument skills are deteriorating and STOP flying IFR.
This pilot didn’t recognizes his current capabilities or was so wrapped up with his medication he couldn’t determine what he was doing. “GROUND thyself”! Those drugs are just band aiding the situation. I knew a com/helicopter pilot who died of dementia and complications within the last year. He grounded himself and didn’t take anyone out with him. EGO is the problem here!