Cause of Piper PA-32R-301 Air Crash in VINEYARD HAVEN, MASSACHUSETTS, USA on 7/16/1999





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Final Report on Probabable Cause of Crash

HISTORY OF FLIGHT

On July 16, 1999, about 2141 eastern daylight time, a Piper PA-32R-301, Saratoga II, N9253N, was destroyed when it crashed into the Atlantic Ocean approximately 7 1/2 miles southwest of Gay Head, Martha's Vineyard, Massachusetts. The certificated private pilot and two passengers received fatal injuries. Night visual meteorological conditions (VMC) prevailed, and no flight plan had been filed for the personal flight conducted under the provisions of 14 Code of Federal Regulations (CFR) Part 91. The flight originated from Essex County Airport (CDW), Caldwell, New Jersey, and was destined for Barnstable Municipal-Boardman/Polando Field (HYA), Hyannis, Massachusetts, with a scheduled stop at Martha's Vineyard Airport (MVY), Vineyard Haven, Massachusetts.

During interviews, witnesses stated that the purpose of the flight was to fly to Martha's Vineyard to drop off one passenger and then continue to HYA. An employee of a fixed-base operator (FBO) at CDW stated that he had called the pilot about 1300 on the day of the accident to verify that the pilot intended to fly the airplane, N9253N, over the weekend. The pilot informed the employee that he did plan to fly the airplane and that he would arrive at the airport between 1730 and 1800. The employee informed the pilot that he would have the airplane parked outside of the hangar.

Witnesses who were at CDW on the night of the accident stated that they saw the pilot and a female near the accident airplane. The witnesses also reported that they saw the pilot using crutches and loading luggage into the airplane. One witness stated that he watched the pilot perform an engine run-up and then take off about 2040. The witness further stated that "takeoff and right downwind departure seem[ed] normal."

According to air traffic control (ATC) transcripts from CDW's tower, about 2034, the pilot of N9253N contacted the ground controller and stated, "...saratoga niner two five three november ready to taxi with mike...right turnout northeast bound." The ground controller instructed the pilot to taxi to runway 22, which the pilot acknowledged. At 2038:32, the pilot of N9253N contacted the tower controller and advised that he was ready to take off from runway 22. At 2038:39, the tower controller cleared N9253N for takeoff; at 2038:43, the pilot acknowledged the clearance. A few seconds later, the tower controller asked the pilot if he was heading towards Teterboro, New Jersey. The pilot replied, "No sir, I'm uh actually I'm heading a little uh north of it, uh eastbound." The tower controller then instructed the pilot to "make it a right downwind departure then." At 2038:56, the pilot acknowledged the instruction stating, "right downwind departure two two." No records of any further communications between the pilot and ATC exist.

According to radar data, at 2040:59, a target transmitting a visual flight rules (VFR) code was observed about 1 mile southwest of CDW at an altitude of 1,300 feet. The target proceeded to the northeast, on a course of about 55 degrees, remaining below 2,000 feet. The target was at 1,400 feet when it reached the Hudson River. When the target was about 8 miles northwest of the Westchester County Airport (HPN), White Plains, New York, it turned north over the river and began to climb. After proceeding north about 6 miles, the target turned eastward to a course of about 100 degrees. The target continued to climb and reached 5,500 feet about 6 miles northeast of HPN. When the target's course was plotted on a New York VFR navigational map, the extended course line crossed the island of Martha's Vineyard.

The target continued eastward at 5,500 feet, passing just north of Bridgeport, Connecticut, and crossed the shoreline between Bridgeport and New Haven, Connecticut. The target ground track continued on the 100-degree course, just south and parallel to the Connecticut and Rhode Island coastlines. After passing Point Judith, Rhode Island, the target continued over the Rhode Island Sound.

A performance study of the radar data revealed that the target began a descent from 5,500 feet about 34 miles west of MVY. The speed during the descent was calculated to be about 160 knots indicated airspeed (KIAS), and the rate of descent was calculated to have varied between 400 and 800 feet per minute (fpm). About 2138, the target began a right turn in a southerly direction. About 30 seconds later, the target stopped its descent at 2,200 feet and began a climb that lasted another 30 seconds. During this period of time, the target stopped the turn, and the airspeed decreased to about 153 KIAS. About 2139, the target leveled off at 2,500 feet and flew in a southeasterly direction. About 50 seconds later, the target entered a left turn and climbed to 2,600 feet. As the target continued in the left turn, it began a descent that reached a rate of about 900 fpm. When the target reached an easterly direction, it stopped turning; its rate of descent remained about 900 fpm. At 2140:15, while still in the descent, the target entered a right turn. As the target's turn rate increased, its descent rate and airspeed also increased. The target's descent rate eventually exceeded 4,700 fpm. The target's last radar position was recorded at 2140:34 at an altitude of 1,100 feet. (For a more detailed description of the target's [accident airplane's] performance, see Section, "Tests and Research," Subsection, "Aircraft Performance Study.")

On July 20, 1999, about 2240, the airplane's wreckage was located in 120 feet of water, about 1/4 mile north of the target's last recorded radar position.

The accident occurred during the hours of darkness. In the area of and on the night of the accident, sunset occurred about 2014. Civil twilight ended about 2047, and nautical twilight ended about 2128. About 2140, the moon was about 11.5 degrees above the horizon at a bearing of 270.5 degrees and provided about 19 percent illumination. The location of the accident wreckage was about 41 degrees, 17 minutes, 37.2 seconds north latitude; 70 degrees, 58 minutes, 39.2 seconds west longitude.

PILOT INFORMATION

The pilot obtained his private pilot certificate for "airplane single-engine land" in April 1998. He did not possess an instrument rating. He received a "high performance airplane" sign-off in his Cessna 182 in June 1998 and a "complex airplane" sign-off in the accident airplane in May 1999. His most recent Federal Aviation Administration (FAA) second-class medical certificate was issued on December 27, 1997, with no limitations.

A copy of the pilot's logbook that covered from October 4, 1982, to November 11, 1998, was provided to the Safety Board. The pilot's most recent logbook was not located. The Board used the copied logbook, records from training facilities, copies of flight instructors' logbooks, and statements from instructors and pilots to estimate the pilot's total flight experience. The pilot's estimated total flight experience, excluding simulator training, was about 310 hours, of which 55 hours were at night. The pilot's estimated experience flying without a certified flight instructor (CFI) on board was about 72 hours. The pilot's estimated flight time in the accident airplane was about 36 hours, of which 9.4 hours were at night. Approximately 3 hours of that flight time was without a CFI on board, and about 0.8 hour of that time was flown at night, which included a night landing. In the 15 months before the accident, the pilot had flown about 35 flight legs either to or from the Essex County/Teterboro, New Jersey, area and the Martha's Vineyard/Hyannis, Massachusetts, area. The pilot flew over 17 of these legs without a CFI on board, including at least 5 at night. The pilot's last known flight in the accident airplane without a CFI on board was on May 28, 1999.

Pilot Training

On October 4, 1982, the pilot started receiving flight instruction. Over the next 6 years, he flew with six different CFIs. During this period, the pilot logged 47 hours, consisting of 46 hours of dual instruction and 1 hour without a CFI on board. The pilot mad

Initial Report

The noninstrument-rated pilot obtained weather forecasts for a cross-country flight, which indicated visual flight rules (VFR) conditions with clear skies and visibilities that varied between 4 to 10 miles along his intended route. The pilot then departed on a dark night. According to a performance study of radar data, the airplane proceeded over land at 5,500 feet. About 34 miles west of Martha's Vineyard Airport, while crossing a 30-mile stretch of water to its destination, the airplane began a descent that varied between 400 to 800 feet per minute (fpm). About 7 miles from the approaching shore, the airplane began a right turn. The airplane stopped its descent at 2,200 feet, then climbed back to 2,600 feet and entered a left turn. While in the left turn, the airplane began another descent that reached about 900 fpm. While still in the descent, the airplane entered a right turn. During this turn, the airplane's rate of descent and airspeed increased. The airplane's rate of descent eventually exceeded 4,700 fpm, and the airplane struck the water in a nose-down attitude. Airports along the coast reported visibilities between 5 and 8 miles. Other pilots flying similar routes on the night of the accident reported no visual horizon while flying over the water because of haze. The pilot's estimated total flight experience was about 310 hours, of which 55 hours were at night. The pilot's estimated flight time in the accident airplane was about 36 hours, of which about 9.4 hours were at night. About 3 hours of that time was without a certified flight instructor (CFI) on board, and about 0.8 hour of that was flown at night and included a night landing. In the 15 months before the accident, the pilot had flown either to or from the destination area about 35 times. The pilot flew at least 17 of these flight legs without a CFI on board, of which 5 were at night. Within 100 days before the accident, the pilot had completed about 50 percent of a formal instrument training course. A Federal Aviation Administration Advisory Circular (AC) 61-27C, "Instrument Flying: Coping with Illusions in Flight," states that illusions or false impressions occur when information provided by sensory organs is misinterpreted or inadequate and that many illusions in flight could be caused by complex motions and certain visual scenes encountered under adverse weather conditions and at night. The AC also states that some illusions might lead to spatial disorientation or the inability to determine accurately the attitude or motion of the aircraft in relation to the earth's surface. The AC further states that spatial disorientation, as a result of continued VFR flight into adverse weather conditions, is regularly near the top of the cause/factor list in annual statistics on fatal aircraft accidents. According to AC 60-4A, "Pilot's Spatial Disorientation," tests conducted with qualified instrument pilots indicated that it can take as long as 35 seconds to establish full control by instruments after a loss of visual reference of the earth's surface. AC 60-4A further states that surface references and the natural horizon may become obscured even though visibility may be above VFR minimums and that an inability to perceive the natural horizon or surface references is common during flights over water, at night, in sparsely populated areas, and in low-visibility conditions. Examination of the airframe, systems, avionics, and engine did not reveal any evidence of a preimpact mechanical malfunction.
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1999 Piper MASSACHUSETTS

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