CEN11FA431

NTSB accident investigation · Bosonetto Thorp T-18 · Howell, MI · June 29, 2011

Accident · FatalField investigationFinal report
Date
June 29, 2011, 19:15 local (23:15 UTC)
Place
Howell, MI
Injuries
2 fatal
Damage
Substantial damage
Phase of flight
Approach
Aircraft
N8ALBosonetto Thorp T-18
Defining event
Approach-VFR pattern final: Loss of control in flight
Weather
Visual (VMC) · Day
Status
Completed · report May 14, 2014
Report
Approved by Office Director
NTSB office
Central Region
Parties
Federal Aviation Administration East Michigan FSDO
FAA report
20110629018199A
Case key
80942

From the NTSB’s public API. By law, NTSB reports can’t be used as evidence in lawsuits over the accident.

On this page

Probable cause

The pilot's failure to maintain airplane control and airspeed during final approach, which resulted in an aerodynamic stall/spin at a low altitude.

Findings · 2

NTSB’s coded findings. Those marked are part of the probable cause; the rest are factors or other findings. Under each, the cases with the same finding.

Performance/control parameters: airspeedAircraft › Aircraft oper/perf/capability · Not attained/maintainedBosonetto Allen R. THORP T-18: 1 caseAll aircraft: 1,681 casesProbable cause

Sequence of events

The events NTSB coded, in order, by phase of flight. The defining event is the one that best describes the accident. Under each, the cases with the same event anywhere in their sequence.

Analysis

The purpose of the accident flight was for the pilot to obtain a flight review in the airplane that he owned. A witness reported seeing the airplane at a higher-than-normal glidepath to the runway and traveling at a slow airspeed while in a forward-slip maneuver. (A forward slip is a flight maneuver used to increase the descent rate, while maintaining airplane pitch and airspeed.) The witness stated that, while the airplane was in the forward slip and losing altitude, it suddenly entered a right spin and descended out of his view. Another witness reported seeing the airplane yawing side-to-side as it approached the runway and then hearing the engine increase to full power as the airplane simultaneously pitched up. The airplane then nosed over and descended into his front yard. A postaccident examination of the airplane revealed no evidence of mechanical malfunctions or failures that would have precluded normal operation. The low-altitude stall/spin encountered during final approach was likely not recoverable. Toxicological testing revealed the presence of several medications in both the pilot and flight instructor; however, it is not likely that they resulted in any impairment.

Factual narrative

HISTORY OF FLIGHT On June 29, 2011, at 1915 eastern daylight time, an experimental amateur-built Bosonetto model Thorp T-18, N8AL, was substantially damaged when it impacted terrain and a house while maneuvering to land at the Livingston County Airport (OZW) near Howell, Michigan. The pilot and flight instructor were fatally injured. The airplane was registered to and operated by the private pilot under the provisions of 14 Code of Federal Regulations Part 91 without a flight plan. Day visual meteorological conditions prevailed for the instructional flight, which originated at an unknown time from Canton-Plymouth-Mettetal Airport (1D2) near Plymouth, Michigan. The purpose of the accident flight was for the pilot to obtain a flight review. A witness to the accident, who was located in his airplane near the departure end of runway 31, reported seeing the airplane in the traffic pattern for runway 31. He stated that after the airplane had turned onto the final approach it was higher than the normal glide-path to the runway and appeared to be traveling at a slow airspeed while in a forward-slip maneuver. (A forward slip is a flight maneuver used to increase the descent rate, while maintaining airplane pitch and airspeed.) The witness stated that while the airplane was in the forward-slip, losing altitude, it suddenly entered a spin to the right and descended out of his view. Another witness, who was inside his residence located along the final approach path, reported that he saw the airplane yawing side-to-side as it approached runway 31. He stated that he heard the airplane engine increase to what sounded like full power simultaneously as the airplane pitched-up. The airplane then nosed-over and descended into his front yard before ultimately colliding with the south wall of his residence. The witness reported that the engine continued to operate at full power until the airplane collided with his residence. Another witness, who was driving westbound on M-59 toward the airport, reported seeing the airplane on final approach to runway 31 when it suddenly rolled to the left and right before it descended behind a nearby treeline and out of his sightline. PERSONNEL INFORMATION -- Pilot -- According to Federal Aviation Administration (FAA) records, the pilot, age 43, held a private pilot certificate with a single engine land airplane rating. His last aviation medical examination was completed on November 7, 2006, when he was issued a third-class medical certificate with no limitations or restrictions. A search of FAA records showed no previous accidents, incidents, or enforcement proceedings. The most recent pilot logbook entry was dated November 13, 2010. At that time, the pilot had accumulated 166.3 hours total flight time. The logbook indicated that all of his flight experience had been completed in single-engine land airplanes, which included 43.4 hours in the accident airplane. The first flight in the accident airplane was dated February 8, 2009.The logbook indicated that he had flown 13.2 hours during the past year; none of that time was during the previous 6 months. However, the accident airplane's hour meter suggested that the pilot could have flown as many as 6.6 hours in the accident airplane during the 6 month period preceding the accident. The pilot's previous flight review was completed on April 5, 2009, in a Cessna model 152 airplane. The pilot's flight logbook included an endorsement to operate tailwheel equipped airplanes, which was dated February 17, 2007. -- Flight Instructor -- According to FAA records, the flight instructor, age 70, held a commercial pilot certificate with single engine land airplane and instrument airplane ratings. He also held a flight instructor certificate with single engine airplane and instrument airplane ratings. His last aviation medical examination was completed on December 24, 2010, when he was issued a third-class medical certificate with a limitation that he wear lenses for distance vision and possess glasses for near vision. A search of FAA records showed no previous accidents, incidents, or enforcement proceedings. The most recent pilot logbook entry was dated July 1, 2010, when the flight instructor completed a flight review in a Piper model PA-28R airplane. The logbook did not include any forwarded flight times, and as such, an accurate flight history could not be determined with the information collected during the investigation. According to FAA records, on December 13, 2006, the flight instructor reported having accumulated 4,750 total flight hours on his application for a medical certificate. He did not report his flight experience on subsequent medical applications. The flight instructor kept a provisional record of his completed flights in his personally owned Piper model PA-28R airplane. According to this airplane flight log, his last recorded flight was completed on June 27, 2011. He had flown the Piper model PA-28R airplane 100 hours during the past year, 45 hours during the prior 6 months, 19 hours during previous 90 days, and 4 hours during the preceding 30 days. The flight instructor reportedly had not flown with the pilot or in the accident airplane before the accident flight. AIRCRAFT INFORMATION The accident airplane was a 1982 Bosonetto model Thorp T-18 amateur-built airplane, serial number (s/n) 238. A 150-horsepower Lycoming model O-320-A1A reciprocating engine, s/n L-2285-27, powered the airplane. The airplane was equipped with a fixed-pitch, two blade, Sensenich model W66LM74 wood propeller. The tail wheel-equipped airplane had a maximum takeoff weight of 1,600 pounds. The accident airplane was issued an experimental airworthiness certificate on November 10, 1982. The airplane was reissued an airworthiness certificate on July 9, 1987, after it was modified with a new engine and propeller combination. The airplane hour meter indicated 268.7 hours at the accident site. The airframe had accumulated a total service time of577.1 hours at the time of the accident. The engine had accumulated 127.9 hours since a field overhaul on July 9, 1987. The last condition inspection was completed on June 1, 2011, at 571.5 total airframe hours. A postaccident review of the maintenance records found no history of unresolved airworthiness issues. METEOROLOGICAL INFORMATION At 1914, the OZW automated surface observing system (ASOS) reported: wind from 300 degrees at 7 knots, visibility 10 miles, clear sky, temperature 25 degrees Celsius, dew point 8 degrees Celsius, and an altimeter setting of 30.06 inches of mercury. AERODROME INFORMATION The Livingston County Airport (OZW) was located about 3 miles northwest of Howell, Michigan, was served by a single runway: 13/31 (5,002 feet by 100 feet, concrete). The airport elevation was 962 feet mean sea level (msl). The elevation of the runway 31 threshold was 943 feet msl. A four-light precision approach path indicator (PAPI) was installed for runway 33. WRECKAGE AND IMPACT INFORMATION A postaccident investigation confirmed that all airframe structural and flight control components were located at the accident site. The main wreckage was located about 0.34 miles southeast of the runway 31 threshold and was facing a north-northwest heading. A ground depression consistent with an initial impact of the aft fuselage was located about 40 feet south-southeast of the main wreckage in a residential front yard. The ground depression continued on a north-northwest heading to where the airplane had impacted a brick wall of a residence. The main wreckage consisted of the entire airframe, flight controls, and engine. A fractured propeller blade was found underneath the aft fuselage. There were additional propeller blade fragments located along the wreckage debris path and in the back yard of the residence. All observed structural component failures were consistent with overstress separation. Flight control continuity was established between the individual flight control surfaces and their respective cockpit controls. The flap position could not be determined due to impact damage. The throttle and mixture controls were found in the full forward position. The carburetor heat control was found partially engaged. The magneto switch was found in the LEFT position. The fuel tank, located in the forward fuselage behind the instrument panel, was breached consistent with impact damage and contained residual fuel. The engine remained attached to the firewall. Internal engine and valve train continuity was confirmed as the engine crankshaft was rotated. Compression and suction were noted on all cylinders in conjunction with crankshaft rotation. The upper spark plugs were removed and exhibited features consistent with normal engine operation. Both magnetos provided spark on all leads when rotated. There were no obstructions between the air filter housing and the carburetor inlet. The fuel supply line to the carburetor and the carburetor bowl both contained fuel.A fuel sample was free of any water or particulate contamination. The carburetor inlet screen was free of any particulate contamination. Mechanical continuity was confirmed from the engine components to their respective cockpit engine controls. The postaccident examination of the airframe and engine revealed no evidence of mechanical malfunctions or failures that would have precluded normal operation. MEDICAL AND PATHOLOGICAL INFORMATION On June 30, 2011, autopsies were performed on the pilot and flight instructor at Sparrow Forensic Pathology Services located in Lansing, Michigan. The cause of death for the pilot and flight instructor was attributed to multiple injuries sustained during the accident. The FAA's Civil Aerospace Medical Institute (CAMI) in Oklahoma City, Oklahoma, performed toxicology tests on samples obtained during the pilot's autopsy. No carbon monoxide, cyanide, or ethanol was detected. Amlodipine was detected in urine and blood samples. Amlodipine is a long-acting calcium channel blocker used to lower blood pressure and to treat anginal chest pain. CAMI performed tests on samples obtained during the flight instructor's autopsy. No carbon monoxide or ethanol was detected. 0.6 ug/ml of cyanide was detected in blood samples. Alfuzosin was detected in blood and urine samples. Azacyclonol was detected in urine samples but not in blood samples. Dextromethorphan and dextrorphan were detected in urine and blood samples. Fexofenadine was detected in urine and blood samples. Naproxen was detected in urine samples. Rosuvastatin was detected in urine samples but not in blood samples. Alfuzosin, brand name Uroxatral, is a medication for benign prostatic hypertrophy and has minimal cardiovascular effects. Dextromethorphan, sold under multiple brand names, is a cough medication and is metabolized into dextrorphan. Fexofenadine, brand name Allegra, is a non-sedating antihistamine and is metabolized into azacyclonol. Naproxen, brand name Alleve, is a non-sedating analgesic. Rosuvastatin, brand name Crestor, is a medication to treat high cholesterol and prevent heart disease. SURVIVAL ASPECTS According to first responders, upon their arrival at the accident site, the pilot was not wearing his lap-belt or shoulder harness. The flight instructor was wearing both his lap-belt and shoulder harness.

Aircraft

Registration
N8AL
Reported as
Bosonetto Thorp T-18
Category
Airplane, amateur-built
Serial number
238
Built
1982
Airframe hours
577
Engine
Lycoming O-320-A1A, 150 horsepower, reciprocating
Damage
Substantial damage
Flight
Instructional · Part 91
Airworthiness certificate
Special, Experimental (Special)
Last inspection
Condition · June 1, 2011 · 6 hours before
Departed
1D2 · Plymouth, MI
Destination
OZW · Howell, MI
Airport
OZW · Livingston County Airport, runway 31, 5,002 × 100 ft, concrete
Equipment
Handheld GPS, Angle of attack indicator

Matched to the registry by N-number and the event date; the registry’s history has gaps, so older matches can be wrong. Compare the reported make and model.

Flight crew · 2

As NTSB recorded them. NTSB leaves out names.

Role
Pilot
Age
43
Injuries
Fatal
Certificate
Private
Airplane ratings
Single-engine land
Medical
Class 3, Without waivers/limitations
Last flight review
April 5, 2009
Seat
Left
Restraint
None
Toxicology
Performed
Flight hours
166 total · 43 in this make and model
Role
Flight instructor
Age
70
Injuries
Fatal
Certificates
Flight instructor, Commercial
Airplane ratings
Single-engine land
Instrument ratings
Airplane
Medical
Class 3, With waivers/limitations
Last flight review
July 1, 2010
Seat
Right
Restraint
3-point
Toxicology
Performed
Flight hours
4,750 total · 0 in this make and model

Weather

Conditions
Visual (VMC) · Day
Wind
300° at 7 knots
Visibility
10 statute miles
Lowest ceiling
None
Temperature
77 °F, dew point 46 °F
Altimeter
30.05 inHg
Observed at
OZW

Docket · 16

The files NTSB released with the investigation on May 8, 2014, on NTSB’s docket system: statements, records, photos and specialists’ reports. 8.6 MB in all.

FAA reports on this event · 1

The FAA’s own accident and incident reports, matched to the aircraft by N-number and date.