Grants Pass, OR, USA
N863Y
Harshbarger W/Reed RV-8
The pilot/builder of the RV-8, in preparation for the sale of the aircraft, had been conducting taxi tests and power checks for several days before the accident. Additionally, the aircraft had not been flown in about a year. On the afternoon of the accident he departed runway 30 and shortly thereafter radioed that he was having engine problems and was going to try to make it back to the airport. Witnesses observed the aircraft midfield on downwind at the time these transmissions were made but the aircraft continued well past the abeam position and did not commence the base turn until about one-half mile beyond the abeam position. The aircraft struck scrub trees at the midspan location of each wing and then crashed in a lightly wooded area approximately 3,300 feet short of the threshold of runway 30. The cockpit interior space sustained no deformation or space reduction with the exception of an impact at the top edge of the aluminum glare shield, and the instrument panel was intact with no broken/cracked instrument glass. The pilot was found with his seatbelt fastened and his shoulder harness unfastened and behind him at the accident site. A review of the pilot's personal medical records revealed that the pilot was taking amitriptyline (a prescription antidepressant also known by the trade name Elavil) for insomnia, and hydrocodone (a prescription narcotic) for chronic abdominal pain. Nortriptyline (a prescription antidepressant and metabolite of amitriptyline) was found at very high levels in the pilot's blood. In addition, a low level of doxylamine (an over-the-counter sleep aid) was detected in the pilots blood and amitriptyline, nortriptyline, doxylamine, hydrocodone, and metabolites of hydrocodone were detected in his urine. Post-crash examination revealed no mechanical malfunction with the aircraft's powerplant, systems or controls with the exception of the aircraft's Bendix fuel servo which, upon disassembly, was found to have extensive internal corrosion and contamination.
HISTORY OF FLIGHT On June 20, 2003, approximately 1425 Pacific daylight time, a Harshbarger/Reed homebuilt Vans RV-8, N863Y, registered to and being flown by a private pilot, sustained substantial damage during a collision with trees during a forced landing following a total loss of power in the landing pattern at the Grants Pass airport (3S8), Grants Pass, Oregon. The pilot was fatally injured during the forced landing and there was no fire. Visual meteorological conditions existed and no flight plan had been filed. The flight, which was personal, was operated under 14CFR91, and originated from 3S8 approximately five minutes earlier. The airport operations officer reported that the aircraft departed around 1420 and shortly thereafter radioed on the airport UNICOM frequency that he was "...having engine problems..." and was on downwind midfield for runway 30. The pilot reported the he was "...going to try to make it back to the field..." and a short time later reported that he was on base and couldn't make the field (refer to Witness Statement W-I). A flight instructor, who observed the aircraft from the airport, reported that he saw the aircraft on downwind for runway 30 after hearing of the radio broadcast of engine trouble. He stated that the aircraft was midfield and at pattern altitude in level flight and did not appear to be descending. The plane did not turn at the abeam position but continued southeast on the downwind for about one-half a mile and then turned on the base leg. He indicated that the aircraft was now descending rapidly and when nearing the extended centerline it disappeared behind trees (refer to Witness Statement W-II). PERSONNEL INFORMATION The pilot held a private pilot certificate with airplane single/multi-engine land ratings. He also held an experimental aircraft repairman certificate (RV-6 model). His last medical, a third class, was issued November 7, 2001. He reported a total of 5,380 flight hours as of that date with a total of 12 hours within the previous 12 months. A review of the pilot's personal and FAA medical records for a one year period back from the date of the accident as well as the review of the post mortem report was conducted by the Safety Board's Medical Officer. The review revealed that the pilot was taking prescriptions including Zantac, amytriptyline, hydrocodone/acetaminophin, Questran, pancreatic enzyme supplements, and Aciphex (refer to Attachment MRI-I). AIRCRAFT INFORMATION According to the aircraft logbook, N863Y, an experimental/kit built RV-8 was manufactured by Reed/Harshbarger on February 1, 2000. The aircraft log showed an entry dated July 2002 at a total (tach) time of 82.7 hours. This entry opened with "Began annual inspection" and continued with a description of the maintenance carried out (refer to attachment L-I). The next (and final) page in the aircraft log was dated March 2003 at a total (tach) time of 98.6 hours (refer to attachment L-I). Both entries were signed off by the pilot/owner. The aircraft was equipped with an engine with an aluminum data plate marked "Aerosport" and the aircraft logbook showed the engine as a Lycoming IO-360-A1B6. Acquaintances of the pilot and airport personnel reported that the pilot had been conducting taxi tests and power checks for several days before the accident and that the aircraft was in the process of being sold. They also reported that the aircraft had not been flown in about a year. The pilot's wife reported that the aircraft's fuel tanks were topped off on June 18th and confirmed that the aircraft had been taxied with power checks on June 18 through the 20th. WRECKAGE AND IMPACT INFORMATION The aircraft crashed in a lightly wooded area approximately 3,300 feet short of the threshold of runway 30 and close to the extended centerline (refer to CHART I and photograph 1) southeast of the Grants Pass airport, Grants Pass, Oregon. The latitude and longitude of the ground impact site was 42 degrees 29.984 minutes North and 123 degrees 22.620 minutes West respectively and the estimated elevation was 1,100 feet above mean sea level. The aircraft was observed at the ground impact site with its longitudinal axis oriented roughly north/south (nose north) along an approximate +12 degree grade. The outboard sections of both wings had separated and the inboard wing spar sections displayed significant aftward bending deformation. The propeller was positioned in the horizontal and there was no other major damage to the airframe, cockpit area and empennage (refer to photographs 2 through 4). Approximately 37 feet south of the aircraft were two scrub trees each with a trunk measuring about one foot in diameter. The two trees were oriented along an east/west line and were 16 feet apart (trunk to trunk). Paint chips and wing fragments were found at the bases of both trees (refer to graphic image 1). MEDICAL AND PATHOLOGICAL INFORMATION Post-mortem examination of the pilot was conducted by James S. Olson, M.D., Deputy State Medical Examiner, at the Oregon State Police Morgue, Central Point, Oregon, on June 24, 2003, (case number A-77-03). "Contained within the autopsy report was the notation that "...adhesions are present around the gallbladder bed. ..." Review of the pilot's personal medical records indicated that he had received prescriptions for hydrocodone/acetaminophen (7.5/750), 60 doses with one refill, on 11/6/01 and 10/31/02. The records further indicated on 4/21/03 that he had been taking amitriptyline (40mg at night) for chronic insomnia and that he "...had no further bouts of abdominal pain since his sphincterotomy and removal of common duct stones May 2002 ...." The FAA's Toxicology Accident and Research Laboratory, Oklahoma City, Oklahoma conducted toxicological evaluation of samples from the pilot. The following findings were reported: >>0.095 (ug/ml, ug/g) HYDROCODONE detected in urine >>0.03 (ug/ml, ug/g) HYDROMORPHONE detected in urine >>0.021 (ug/ml, ug/g) DIHYDROCODEINE detected in urine >>OPIATES NOT detected in blood >>0.308 (ug/ml, ug/g) NORTRIPTYLINE detected in blood >>NORTRIPTYLINE present in urine >>AMITRIPTYLINE present in urine >>DOXYLAMINE present in blood >>DOXYLAMINE present in urine No carbon monoxide, cyanide or ethanol was detected (refer to attached TOX report). SURVIVAL ASPECTS According to local law enforcement personnel who arrived on scene immediately following the accident, the pilot was secured by his seat belt in the aircraft. The shoulder harness, however, was found unclipped and behind the pilot. An examination of the cockpit area determined that the cockpit interior space had not suffered any deformation or reduction and the instrument panel was intact with no broken/cracked instrument glass. The aft edge of the instrument glare shield cover, an aluminum cover above the instrument panel, was observed deformed in a forward direction consistent with an object impacting in forward motion. TESTS AND RESEARCH The aircraft and accident site were re-examined on July 9, 2003, during which flight control and engine control continuity was verified. An examination of the engine revealed no mechanical malfunction with acceptable thumb compression observed for each of the four cylinders and complete continuity throughout the engine. Fuel was observed in fuel lines up through the fuel flow divider and several quarts were recovered from the left wing tank and fed through the fuel selector up to the fuel injector lines. When electrical power was applied to the aircraft's system and the boost pump was turned on fuel was observed exiting each of the four injector lines. A moderate fuel leak was observed coming from the gascolator cover seal during the test. The gascolator lies upstream from the engine driven fuel pump. It could not be established whether this leak pre-existed the accident or was a result of impact during the accident. The two Bendix magnetos (S4LN-1209, s/n: A181319, and S4LN-1227, s/n: 183370) were removed and bench checked. Both units were found to operate normally. The Bendix fuel servo (RSA-5AD1, s/n: 37497) was flow checked and then disassembled and examined. The disassembly revealed extensive internal corrosion and contamination (refer to attachment PAM-I). ADDITIONAL INFORMATION An inspector assigned to the Federal Aviation Administration's Hillsboro, Oregon, Flight Standards District Office conducted the initial on-site examination of the wreckage on June 21, 2003, after which it was moved to the owner's hangar where it was secured. At the conclusion of the follow-up examination on July 9, 2003, the wreckage, exclusive of the magnetos and fuel servo, was formally released to the pilot's wife (refer to attached NTSB form 6120.15). Both the magnetos and the fuel servo were subsequently returned to the pilot's wife by September 26, 2003.
Corrosion and contamination within the fuel servo unit and the pilot's delayed turn back to the runway. Contributing factors were trees and the pilot's impairment due to prescription medication.
Source: NTSB Aviation Accident Database
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