Midway, GA, USA
N2246S
CESSNA 210L
The pilot departed on a visual flight rules (VFR) flight into night instrument meteorological conditions (IMC) to an airport that was not equipped with any instrument approach procedures. Automatic dependent surveillance-broadcast (ADS-B) data showed that, in the final minutes of the accident flight, the pilot turned toward the airport, descended below the reported overcast cloud layer, and flew at altitudes between 100 to 300 ft mean sea level at groundspeeds of 100 to 115 knots. While descending, the airplane impacted 80-100 ft tall pine trees about 5 nautical miles from the destination airport. The pilot’s son reported that the pilot used a GPS and an app on his personal electronic device (PED) in which he had “built a flight path” into the destination airport. It was customary for the pilot to use this app and descend to pattern altitude or below cloud level, then continue to the airport by reference to the ground and the app. Postaccident examination of the airplane revealed no preimpact mechanical anomalies that would have precluded normal operation. The distribution of the wreckage indicated that the airplane impacted terrain in a near-level attitude with high forward velocity. There was no indication that the pilot obtained a weather briefing before departure; however, he did discuss the poor weather conditions at the destination airport with his son via text message and stated that he would check the weather before he departed. Although the pilot was instrument rated, he chose to fly VFR in low instrument flight rules (IFR) conditions over a dark swamp into an airport with no instrument approach procedures rather than file an IFR flight plan to an airport with an instrument approach. The pilot was expected at work at a nearby hospital emergency room the next morning, and it is likely that his desire to be at work contributed to his decision. Although conditions were conducive to the development of spatial disorientation, the airplane’s low impact angle was more consistent with controlled flight into terrain rather than a loss of control due to spatial disorientation. The extremely low altitude and moderate speeds at which the pilot was operating under the impoverished visual conditions at the time of the accident, and his reported use of a PED for navigation and hazard avoidance, would have made precise altitude control challenging given the division of attention and workload required. Given the impoverished visual conditions, low altitude, and the distance from the airport, the pilot likely would have had difficulty identifying the airport environment. He may have been attempting to locate the airport and lost awareness of the airplane’s altitude as it continued to descend until it impacted trees.
HISTORY OF FLIGHTOn December 20, 2020, about 2011 eastern standard time, a Cessna 210L, N2246S, was substantially damaged when it was involved in an accident near Midway, Georgia. The private pilot was fatally injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. Earlier on the day of the accident, the pilot flew his airplane from Eagle Neck Airport (1GA0), Shellman Bluff, Georgia, to East Georgia Regional Airport (SBO), Swainsboro, Georgia, where he worked a 12-hour shift in the local emergency room before leaving the medical center around 1915. The pilot exchanged text messages with his son before and during the accident flight. In an exchange of messages sent around 1900, they discussed the instrument meteorological conditions at 1GA0, which were described by his son as low instrument flight rules conditions with “low fog and [a] lot of rain” as well as 400-foot ceilings at Brunswick Golden Isle Airport (BQK), located about 22 nautical miles (nm) south-southwest of 1GA0. The pilot responded that he would check the weather before he left, would depart soon, and that he might stop in Claxton, Georgia, for fuel. A review of automatic dependent surveillance-broadcast (ADS-B) track data provided by the Federal Aviation Administration (FAA) revealed that the pilot departed runway 14 at SBO around 1940. The 1931 reported ceiling at SBO was overcast at 300 ft above ground level (agl). After departure, the airplane initially turned to the east, overflying the town of Swainsboro, before turning back to the right and tracking southeast for the remainder of the flight. The airplane climbed to and maintained an altitude between 2,000 to 2,500 ft mean sea level (msl) during cruise. At 1955, the pilot sent a text message to his son and stated that he was over Claxton, and that he would continue to 1GA0 without stopping. The airplane began descending at 2003 and continued southeast until just north of Seabrook, Georgia. The final minute of flight track data showed that the airplane descended below the reported overcast cloud layer and flew between altitudes of 100 to 300 ft msl at a groundspeed of 100 to 115 knots. The track data ended at 2011, about 0.3 nm north-northwest of the initial impact point. The 1GAO field elevation was 10 ft msl. No flight plan was filed for the flight and no air traffic control services were provided. There were no records of the pilot having obtained a weather briefing from Leidos Flight Services, Direct User Access Terminal Service, or Foreflight before departure. The airplane was located the following day, upright in a marshy area about 5 miles north of 1GA0. PERSONNEL INFORMATIONThe pilot’s logbook was found during recovery of the airplane. The last page of the logbook included the early morning flight on December 20 from 1GA0 to SBO. The entry indicated 5,192.7 hours, which appeared to correspond with an engine tachometer time, and the note “Night IFR.” During examination of the wreckage, the tachometer time was noted as 5,193.3 hours. The pilot’s son stated that his father used a Garmin 430 GPS unit and a Garmin aviation app on his personal electronic device (PED). He explained that using the Garmin app on his PED, his father had “built a flight path into Eagle Neck and he would look at the app as a reference to know where he was along his planned flight path.” He explained that his father “had waypoints set up on the Garmin 430s that were lined up with the runway at Eagle Neck” and that the waypoints were “at the ends of the runways . . . one in the middle of the marsh, and about two waypoints between the interstate and the runway.” He stated that his father “knew where the waypoints were located relative to the marsh and the runway…He would show the interstate on the Garmin app, and when he crossed the interstate, he would descend to pattern altitude (which was 1000 ft), but when he was IFR he would descend below the cloud level and follow the waypoints. When he could see the runway, he would then continue to land…When he crosses over the interstate, he knows that he can descend to a 1,000 ft. If he still cannot see the runway, he descends further, then continues VFR. One waypoint is over a house with a red roof that serves as short final, about 5 miles out from the runway.” AIRCRAFT INFORMATIONThe pilot logbook found during recovery of the wreckage stated, “Overhaul 7/12 @ 4117,” and, “New Engine 5/2018 4825.” No additional maintenance records were obtained. METEOROLOGICAL INFORMATIONThe 2008 reported weather conditions at Wright Army Airfield/Midcoast Regional Airport (LHW), Fort Stewart (Hinesville), Georgia, located about 16 nm north of accident site, included overcast clouds at 600 ft and 7 miles visibility in light drizzle. The airport elevation was 46.6 ft msl. The 2011 weather conditions at Hunter Army Airfield (SVN), Savannah, Georgia, located 20 nm north-northeast of the accident site included overcast clouds at 400 ft and 7 miles of visibility in light rain. These conditions met the criteria for low IFR, which includes ceilings below 500 ft and/or visibility less than 1 mile. The airport elevation was 41.3 ft msl. At 1545, an AIRMET SIERRA for IFR conditions was issued (valid through 2200) for a region that included the accident location and advised of ceilings below 1,000 ft, visibility below 3 statute miles, and precipitation and mist. AIRPORT INFORMATIONThe pilot logbook found during recovery of the wreckage stated, “Overhaul 7/12 @ 4117,” and, “New Engine 5/2018 4825.” No additional maintenance records were obtained. WRECKAGE AND IMPACT INFORMATIONThe NTSB did not travel to the accident site due to Covid-19 travel restrictions. Aerial photographs provided by first responders showed that the airplane cut an approximate 300-ft-long path through 80 to 100-ft-tall pine trees as it descended on a southerly heading. The accident site was located about 5 miles north of 1GA0. The initial point of impact was a tree, and the right wing was located at the base of that tree. The left wing was found near the top of another tree located about 120 ft farther along the debris path, followed by the propeller 50 ft farther, and the initial ground impact scar about 70 ft beyond the propeller. The main wreckage, with the tail and engine attached, came to rest upright about 75 ft beyond the impact ground scar against a small group of trees. There was no evidence of fire. The accident site elevation was about 5 ft msl. The fuselage skin was torn, exposing the cabin and cockpit. The instrument panel was mostly intact. The throttle control was in the idle position, the propeller control was full forward, and the mixture was about 1.5 inches from full rich. The flap handle was in the 20° position. Examination of the wreckage after recovery revealed control cable continuity from the rudder, elevator, and elevator trim tab to the aft fuselage area. Further examination of the cables was not possible due to impact damage. Aileron continuity could not be confirmed due to the wing damage and separation from the fuselage. The elevator trim tab indicator was in a slight nose-down position, just above the takeoff setting. The right elevator sustained tree impact damage; the outboard 8 inches, including the balance weight, was separated and not recovered. The landing gear was found in the retracted position. The fuel selector valve was removed and found in the left tank position. A substantial amount of fuel drained on the floor when the selector valve was removed. Impact damage precluded rotation of the engine crankshaft; however, after removing the oil pan, visual continuity of the crankshaft and camshaft was confirmed. Both magnetos sparked at all leads. Fuel was observed at the fuel pump outlet, the inlet to throttle body fuel control unit, and at the distribution manifold. The fuel pump drive shaft was intact, and fuel was observed in the pump when it was rotated by hand. The left vacuum pump drive shaft was intact; the right vacuum pump drive shaft was sheared. The vanes in both were found intact when viewed through the inspection port. The vane wear was within limits. One propeller blade was curled aft and twisted at the tip with the tip separated. The second blade was bent aft 90° at the tip. The third blade was bent forward at the tip with leading and trailing edge tears at the tip. No engine or airframe anomalies were observed that would have prevented normal operation. ADDITIONAL INFORMATIONFAA Advisory Circular AC 60-22, Aeronautical Decision Making, stated in part: "Pilots, particularly those with considerable experience, as a rule always try to complete a flight as planned, please passengers, meet schedules, and generally demonstrate that they have 'the right stuff.'" One of the common behavioral traps identified was "Get-there-itis." The text stated, "Common among pilots, [get-there-itis] clouds the vision and impairs judgment by causing a fixation on the original goal or destination combined with a total disregard for any alternative course of action." FAA Advisory Circular 61-134, General Aviation Controlled Flight into Terrain Awareness, stated in part: Operating in marginal VFR [visual flight rules]/IMC conditions is more commonly known as scud running. According to National Transportation Safety Board (NTSB) and FAA data, one of the leading causes of GA accidents is continued VFR flight into IMC As defined in 14 CFR part 91, ceiling, cloud, or visibility conditions less than that specified for VFR or Special VFR is IMC and IFR [instrument flight rules] applies. However, some pilots, including some with instrument ratings, continue to fly VFR in conditions less than that specified for VFR. The result is often a CFIT [controlled flight into terrain] accident when the pilot tries to continue flying or maneuvering beneath a lowering ceiling and hits an obstacle or terrain or impacts water. The accident may or may not be a result of a loss of control before the aircraft impacts the obstacle or surface. The importance of complete weather information, understanding the significance of the weather information, and being able to correlate the pilot's skills and training, aircraft capabilities, and operating environment with an accurate forecast cannot be emphasized enough. MEDICAL AND PATHOLOGICAL INFORMATIONToxicology testing performed by the FAA Forensic Sciences Laboratory identified the high blood pressure medications amlodipine and valsartan in the pilot’s urine and blood; these medications are generally considered non-impairing. The testing revealed no drugs of abuse.
The pilot's intentional visual flight rules flight into instrument meteorological conditions, which resulted in controlled flight into terrain. Contributing to the accident was the pressure to complete the flight to work in an emergency room.
Source: NTSB Aviation Accident Database
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