# NTSB CEN11FA247: Stinson 108, N97383, Dickens, TX, March 27, 2011 - Type: NTSB accident investigation - Classification: Accident · Fatal · Field investigation · Final report - Date: March 27, 2011 - Place: Dickens, TX - Coordinates: 33.67361, -100.8675 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=33.6736&lon=-100.8675&mi=10 - Phase of flight: [Unknown](https://openairdocs.org/ntsb-phases/990) (OpenAirDocs' grouping) - Defining event: [Unknown: Loss of control in flight](https://openairdocs.org/ntsb-events/240) - Highest injury: Fatal - Injuries: 3 fatal - Status: Completed, report December 1, 2011 - Report: Approved by Office Director - NTSB office: Central Region - Parties: FAA FSDO - SAIBs cited in the narratives: [SAIB CE-09-35](https://openairdocs.org/saib/CE-09-35) (OpenAirDocs) - NTSB case key (mKey): 78685 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=CEN11FA247 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/78685/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=78685 - Page: https://openairdocs.org/ntsb/CEN11FA247 ## Probable cause The non-instrument rated pilot's decision to fly in night instrument meteorological conditions. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Info processing/decision: decision making/judgment](https://openairdocs.org/ntsb-findings/02041520): Personnel issues › Action/decision · Pilot (probable cause); cases with it: [Stinson 108, 4 cases](https://openairdocs.org/ntsb-findings/02041520/cases.md?model=9230402), [All aircraft, 3,098 cases](https://openairdocs.org/ntsb-findings/02041520/cases.md) - [Light condition: low light](https://openairdocs.org/ntsb-findings/03036015): Environmental issues › Conditions/weather/phenomena · Decision related to condition; cases with it: [Stinson 108, 1 case](https://openairdocs.org/ntsb-findings/03036015/cases.md?model=9230402), [All aircraft, 36 cases](https://openairdocs.org/ntsb-findings/03036015/cases.md) - [Ceiling/visibility/precip: below VFR minima](https://openairdocs.org/ntsb-findings/03035075): Environmental issues › Conditions/weather/phenomena · Decision related to condition; cases with it: [Stinson 108, 1 case](https://openairdocs.org/ntsb-findings/03035075/cases.md?model=9230402), [All aircraft, 184 cases](https://openairdocs.org/ntsb-findings/03035075/cases.md) ## Sequence of events The events NTSB coded, in order, by phase of flight. The defining event best describes what happened. - [Unknown: Loss of control in flight](https://openairdocs.org/ntsb-events/240) (defining event); cases with it: [Stinson 108, 2 cases](https://openairdocs.org/ntsb-events/240/sequence.md?model=9230402), [All aircraft, 5,002 cases](https://openairdocs.org/ntsb-events/240/sequence.md) - [Unknown: Collision with terr/obj (non-CFIT) ](https://openairdocs.org/ntsb-events/470); cases with it: [Stinson 108, 6 cases](https://openairdocs.org/ntsb-events/470/sequence.md?model=9230402), [All aircraft, 10,189 cases](https://openairdocs.org/ntsb-events/470/sequence.md) ## Analysis The airplane impacted terrain in night instrument meteorological conditions. There were no known eyewitnesses who saw the takeoff or accident. The wreckage was located in a pasture area of rolling hills by a local resident, approximately 1.25 miles southeast of the departure airfield. Ground scars and the wreckage path led to the main wreckage, which was oriented on a heading of 100 degrees. The pilot was not instrument rated and it was not determined whether he obtained a weather briefing. Although it is uncertain whether he obtained a weather briefing, the conditions on the night of the accident were obviously instrument conditions with overcast skies at 500 feet. The non-instrument rated pilot exhibited poor decision-making when he elected to fly in those conditions. A postaccident examination of the airframe and engine revealed no anomalies that would have precluded normal operation. ## Factual narrative The four-seat, high-wing, fixed-gear airplane, serial number 108-383, was manufactured in 1946. It was powered by a Franklin 6A4-15-B3, s/n 11542, 150-hp engine driving a Sensenich fixed pitch metal 2-bladed propeller. A review of copies of the maintenance logbook records showed an annual inspection was completed on March 27, 2010, at a recorded tachometer time of 2,350 hours and an engine time since major overhaul of 40 hours. The tachometer was damaged and a current tachometer reading could not be obtained; however, 10 days prior to the accident, a logbook entry recorded the tachometer at 2,588.6 hours. On March 27, 2011, at an undetermined time, a Stinson 108, N97383, was substantially damaged upon impact with terrain near Dickens, Texas. The private pilot and two passengers were fatally injured. The airplane was mostly consumed by a post-impact fire. The airplane was registered to and operated by a private individual under the provisions of 14 Code of Federal Regulations Part 91 as a personal flight. Dark night instrument meteorological conditions prevailed for the flight, which operated without a flight plan. The flight originated from a private airfield and was headed to an unknown refueling stop with the ultimate destination of Rockdale, Texas. According to the pilot's wife, the pilot was planning on departing at 0530; however, the actual departure time is unknown. The wreckage was found about 1300 in a pasture area by a local resident. There are no known witnesses to the accident. An autopsy was performed on the pilot on March 28, 2011, by South Plains Forensic Pathology, Lubbock, Texas, as authorized by the Dickens County Justice of the Peace. The autopsy finding noted the cause of death as a result of blunt force injuries. Forensic toxicology was performed on specimens from the pilot by the FAA Civil Aerospace Medical Institute (CAMI), Oklahoma City, Oklahoma. The following findings were noted: 26 (mg/dL, mg/hg) ETHANOL detected in Muscle NO ETHANOL detected in Liver Notes: The ethanol found in this case is from sources other than ingestion. Chlorpheniramine detected in Liver Chlorpheniramine detected in Kidney The National Institutes of Health (NIH) reports chlorpheniramine in the antihistamine class with drowsiness as a potential side effect. At 0553, an automated weather observation facility at Lubbock International Airport (LBB), located 52 nautical miles to the west, reported winds from 060 degrees at 9 knots, visibility 5 miles with mist, overcast skies at 500 feet, temperature 39 degrees Fahrenheit (F), dew point 36 degrees F., and a barometric pressure of 29.83 inches of Mercury. In addition, automated weather observation facilities at Childress Municipal Airport (CDS), Childress, Texas, located 53 nautical miles north-northeast of the accident site and Winston Field Airport (SNK), Snyder, Texas located 59 nautical miles south, reported weather similar to LBB. According to astronomical data obtained from the U.S. NavalObservatory, civil twilight began at 0713, with a corresponding sunrise of 0738. The moon had risen at 0335 with 38% disk illumination. A review of carburetor icing probability chart located in the FAA's Special Airworthiness Information Bulletin CE-09-35, revealed that the airplane was operating in an area conducive to serious icing at cruise power. The pilot, age 40, held a private pilot certificate for airplane single-engine land issued on May 27, 2008 and did not hold an instrument endorsement. A third-class airman medical certificate issued July 19, 2007, with no limitations. A review of the pilot's logbook revealed the pilot had accumulated over 600 hours total time with over 200 hours in make and model. He had recorded no flight hours in actual instrument conditions and 3.8 hours of simulated instrument conditions. The airplane wreckage was located in an area of rolling hills approximately 1.25 miles southeast of the departure airfield. The vegetation was low-lying and sparse. Ground scars reveal an impact heading of 300 degrees. The ground scar began before a barbed wire fence. Damaged fence materials led to a 2.5 foot deep crater about 13 feet past the fence line. Twelve feet past the crater was the airplane's engine separated completely from the fuselage. Debris continued 14 feet towards the main wreckage which consisted of the fuselage, both wings, and the empennage. The airplane was found upright facing about 100 degrees. Evidence of a post-impact fire began at the impact crater and continued about 65 feet in a 90-degree fan pattern. All airplane components displayed fire damage with a majority of the interior completely consumed in the fire. Flight control continuity was established from the aileron push-pull rods to the flight controls and elevator and rudder continuity was established from the control surfaces to the flight controls. The elevator trim was found in the neutral position. The flap position could not be determined. The engine also displayed signs of thermal damage. The engine crankcase was broken in multiple locations. Cylinders one and six fractured from the crankcase. The sparkplugs displayed normal wear. The engine's crankshaft displayed a slight bend. The carburetor heat shroud was impact damaged, but remained attached to the muffler. Continunity from the shroud to the carburetor could not be determined due to impact and fire damage. Both blades displayed minor polishing at the leading edges. One blade was nearly straight with the other blade bent rearward. ## Aircraft - Registration: [N97383](https://openairdocs.org/deregistered/N97383-2017-06-19), registration cancelled 2017-06-19, S/N 108-383, built 1946 (OpenAirDocs) - Reported make and model: STINSON 108 - Registry model: [Stinson 108](https://openairdocs.org/model/stinson-108) (registry code 9230402) (OpenAirDocs) - Registry engine: [Franklin 6A4150 series](https://openairdocs.org/engine/franklin-6a4150-series) (registry code 27024, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: 108-383 - Airframe hours: 2350 - Engines: FRANKLIN 6A4-150-B3 150 horsepower reciprocating - Damage: Substantial damage - Fire: On-Ground - Flight: Personal, Part 91 - Airworthiness certificate: Standard, Normal; Standard, Utility - Last inspection: Annual, March 27, 2010, 239 hours before - Departed: Dickens, TX - Destination: Rockdale, TX ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 40; injuries: fatal; private; airplane ratings: single-engine land; medical: class 3, without waivers/limitations; last flight review June 5, 2010; seat: left; toxicology performed; flight hours: 600 total, 200 in this make and model ## Weather - Conditions: Instrument (IMC), Night/dark - Wind: 70° at 7 knots - Visibility: 5 statute miles - Lowest ceiling: 500 ft overcast - Temperature: 37 °F, dew point 36 °F - Altimeter: 29.82 inHg - Observed at: LBB, 53 nm away ## FAA reports on this event (1) The FAA's own accident and incident reports, matched to the aircraft by N-number and date (OpenAirDocs). - [Accident 20110327005089A](https://openairdocs.org/incident/20110327005089A), Mar 27, 2011: Stinson 108, Dickens, TX, Destroyed, 3 fatal. On March 27, 2011, about 0600 central daylight time, N97383, a Stinson 108, was destoryed upon impact near Dickens, Texas. The private pilot and two passengers… ## Docket (7 files) The files NTSB released with the investigation on October 3, 2011, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=78685. 739 KB in all. - Pilot/Operator Aircraft Accident Report, NTSB Form 6120.1: not requested (item 1, .PDF, 14 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40351577&FileExtension=.PDF&FileName=Pilot%2FOperator%20Aircraft%20Accident%20Report,%20NTSB%20Form%206120.1%3A%20not%20requested-Master.PDF - Photo: Wreckage and ground scar (item 2, .PDF, 130 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40351578&FileExtension=.PDF&FileName=Photo%3A%20Wreckage%20and%20ground%20scar-Master.PDF - Photo: Airplane's Engine (item 3, .PDF, 207 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40351579&FileExtension=.PDF&FileName=Photo%3A%20Airplane%27s%20Engine-Master.PDF - Photo: Airframe wreckage (item 4, .PDF, 156 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40351580&FileExtension=.PDF&FileName=Photo%3A%20Airframe%20wreckage-Master.PDF - Toxicological Report (item 5, .PDF, 118 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40351582&FileExtension=.PDF&FileName=Toxicological%20Report-Master.PDF - Weather Reports and Records: METAR & TAF for local area. (item 6, .PDF, 92 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40352303&FileExtension=.PDF&FileName=Weather%20Reports%20and%20Records%3A%20METAR%20%26%20TAF%20for%20local%20area.-Master.PDF - Weather Reports and Records: Sunrise & Moon illum data (US Naval Observatory) (item 7, .PDF, 23 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=40352304&FileExtension=.PDF&FileName=Weather%20Reports%20and%20Records%3A%20Sunrise%20%26%20Moon%20illum%20data%20(US%20Naval%20Observatory)-Master.PDF From the NTSB's public API. Aircraft are matched to registry aircraft by N-number and event date, checked against the reported serial number, make and model; the registry's history has gaps, so older matches can be wrong. Compare the reported make and model. --- OpenAirDocs.org is an independent research project of [Contrail Labs](https://contraillabs.com/). It is not affiliated with the FAA or the NTSB. Source documents are U.S. government works in the public domain.