Aviation Accident Summaries

Aviation Accident Summary WPR22FA160

Sylmar, CA, USA

Aircraft #1

N143JB

CESSNA 337

Analysis

Shortly after takeoff, the pilot reported to the tower controller that he was not able to retract the airplane’s landing gear and requested to circle the airport at 2,500 ft. The airplane climbed to and remained at about 2,000 ft for about 2 minutes before entering a descent that continued until ground contact. Witnesses saw the airplane descending in a steep, nose-down attitude, and a surveillance video showed the airplane rotating in a nose-down attitude as it collided with terrain. Examination of the airframe and engines revealed no preaccident mechanical malfunctions or failures that would have precluded normal operation. Toxicology testing of the pilot revealed 65 (mg/dL, mg/hg) ethanol in blood, 133 (mg/dL, mg/hg) ethanol in urine, and 10 (mg/dL, mg/hg) glucose in vitreous fluid. The ethanol production was not attributed to putrefaction. Based on the levels found and their distribution, it is likely that the pilot’s blood ethanol concentrations were around 0.12 gm/dL. It is likely that, while trying to troubleshoot the landing gear issue, the pilot allowed the airplane to slow and exceed its critical angle of attack. The airplane subsequently entered a spin from which the pilot was not able to recover. Given the levels of ethanol found in toxicology testing, the pilot would have likely experienced degradation of judgment, reasoning, and coordination that would have affected his ability to safely manage the airplane, and it is likely that his impairment due to alcohol consumption contributed to his loss of control.

Factual Information

HISTORY OF FLIGHT On April 20, 2022, at 1226 Pacific daylight time, a Cessna 337, N143JB, was substantially damaged when it was involved in an accident near Sylmar, California. The pilot was fatally injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. Review of the recorded communication between the air traffic controller and accident pilot revealed that, shortly after takeoff, the pilot reported to the tower controller that his landing gear did not retract all the way and he would like to stay over the airport. The controller asked the pilot his intentions, to which the pilot replied that he was going to climb to 2,500 ft and circle the airport. The controller instructed the pilot to climb to 2,500 ft and make a left pattern; the pilot acknowledged. There were no further communications received from the pilot despite repeated attempt by the tower controller. Automatic Dependent Surveillance - Broadcast (ADS-B) data showed that the airplane departed runway 12 at Whiteman Airport (WHP), Los Angeles, California. The ADS-B target showed a left turn to a northwesterly heading and a climb to about 2,000 ft mean sea level (msl). The data showed that the airplane continued at an altitude of about 2,000 ft for about 1 minute, 41 seconds until a left 90° turn was observed. At 1226:12, the airplane entered a descent from 1,900 ft. The last ADS-B target was recorded at 1226:19, about 75 ft north-northeast of the accident site at an altitude of 1,500 ft msl. One witness stated that he saw the airplane descending “nose first at a very steep angle.” Another stated that he saw the airplane flying at slow speed before it performed a 180° turn, leveled momentarily, then “nosedived” to the ground. Security video near the accident site captured the impact. Just before the airplane impacted the ground, it could be seen rotating in a nose-down attitude. WRECKAGE AND IMPACT INFORMATION The airplane came to rest on an embankment wedged between two trees, upright and in a nose-low attitude about 80 ft from the roadway. The airplane’s left wing impacted a fence before the airplane struck the ground. The left wing remained near the top of the embankment. The rear engine/propeller assembly separated at the engine crankshaft propeller flange and came to rest just forward of the right wing. The forward propeller assembly also separated at the engine crankshaft propeller flange and was found underneath the engine. Flight control continuity was established from the cockpit area to the respective flight control surfaces. The smell of fuel was present at the accident site, and the left wing outboard and inboard fuel tanks had been breached. The right wing inboard fuel tank had not been breached and fuel was observed in the tank; the outboard right fuel tank had been breached. A postaccident examination of the airframe and engines revealed no evidence of mechanical malfunctions or failures that would have precluded normal operation. Examination of the landing gear revealed that the nose and left main landing gear were in the extended position, and the right main landing gear had separated during the accident sequence; the main landing gear door actuators were determined to be in the extended position. The landing gear handle was in the intermediate position. MEDICAL AND PATHOLOGICAL An autopsy of the pilot was performed by the County of Los Angeles, Department of Medical Examiner-Coroner, Los Angeles, California. The autopsy report was reviewed by the NTSB medical officer. According to the autopsy report, the cause of death was multiple blunt force injuries, and the manner of death was accident. Toxicology testing performed by the FAA Forensic Sciences Laboratory found 65 (mg/dL, mg/hg) ethanol in the pilot’s blood, 133 (mg/dL, mg/hg) ethanol in the pilot’s urine, and 10 (mg/dL) glucose in the pilot’s vitreous. Toxicology testing further revealed no drugs of abuse, and the ethanol detected was not a result of postmortem production. Ethanol is a social drug commonly consumed by drinking beer, wine, or liquor. Ethanol acts as a central nervous system depressant; it impairs judgment, psychomotor functioning, and vigilance.

Probable Cause and Findings

The pilot’s loss of airplane control while troubleshooting a landing gear issue, which resulted in an aerodynamic stall/spin at an altitude too low to recover. Contributing to the accident was the pilot’s impairment from alcohol consumption.

 

Source: NTSB Aviation Accident Database

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