CEN20LA168

NTSB accident investigation · Yakovlev YAK 52 · Palmyra, IL · May 2, 2020

Accident · FatalClass 3 · LimitedFinal report
Date
May 2, 2020, 16:00 local (21:00 UTC)
Place
Palmyra, IL
Injuries
1 fatal
Damage
Destroyed
Phase of flight
Maneuvering
Aircraft
N27YKYakovlev YAK 52
Defining event
Maneuvering-low-alt flying: Loss of control in flight
Weather
Visual (VMC) · Day
Status
Completed
Report
Approved by Office Director
Investigation class
Class 3
NTSB office
Central Region
Parties
FAA
FAA report
20200502007459A
Case key
101228

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

A loss of control during a low-altitude aerobatic maneuver.

Findings · 4

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: altitudeAircraft › Aircraft oper/perf/capability · Not attained/maintainedYakovlev YAK 52: 4 casesAll aircraft: 1,310 casesProbable cause
Performance/control parameters: lateral/bank controlAircraft › Aircraft oper/perf/capability · Not attained/maintainedYakovlev YAK 52: 1 caseAll aircraft: 390 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

Witnesses saw the airplane approach the airport and perform a low-altitude pass 20 to 30 ft above the runway. The airplane then pitched up, climbed about 200 feet, and entered a roll. During the roll, the airplane’s nose dropped, and the airplane descended and impacted the ground in a steep, nose-down attitude. One of the witnesses was familiar with the pilot and had seen the pilot perform similar maneuvers previously. A review of the pilot’s logbooks revealed one entry about three years before the accident flight that suggested some aerobatic training in the accident airplane; however, the extent of the pilot’s aerobatic training could not be determined. Postaccident examination of the airplane revealed no evidence of anomalies; however, impact damage prevented complete examination of the flight control system. Based on autopsy findings, the pilot did not appear to have any natural disease that would be a factor in this accident; however, his toxicology was positive for the anticoagulant warfarin. This medication, while non-impairing, is used to prevent complications of atrial fibrillation or prevent several cardiovascular conditions, such as heart attack and stroke, which can cause sudden incapacitation. This would be especially true for aerial maneuvers that would result in changes in gravitational forces that could trigger heart arrhythmias. The pilot’s FAA third-class medical certificate expired 10 years before this accident, and his current medical status and the reason he was taking warfarin are unknown. Given the operational findings of this accident, the pilot’s use of the medication warfarin and the possible medical conditions for which warfarin was prescribed were unlikely factors in the accident. Ethanol detected in the pilot’s vitreous fluid was likely from sources other than ingestion and did not contribute to the accident. Based on the available information, the circumstances of the accident are consistent with a loss of control during a low-altitude aerobatic maneuver.

Factual narrative

On May 2, 2020, about 1600 central daylight time, a Yakovlev YAK-52 airplane, N27YK, was destroyed when it was involved in an accident near Palmyra, Illinois. The pilot was fatally injured. The airplane was operated as a Title 14 Code of Federal Regulations (CFR) Part 91 personal flight. A witness north of Zelmer Memorial Airpark Inc (5K1), Palmyra, Illinois, saw the airplane descend toward the airport at high speed, “way too fast to be landing.” He lost sight of the airplane as it descended behind a tree line. A few moments later, he saw the airplane climb into sight 200 to 300 ft above ground level (agl) about 1.5 miles away, start to roll, and descend steeply into the ground. A pilot witness observed the airplane make a low pass over the airport around 20 to 30 ft agl. He stated that the airplane pitched up 5 to 10° to about 100 to 200 ft agl when it was past the end of the runway and made a slow roll to the left. As the airplane rolled inverted, he did not think the pilot had enough altitude to perform the maneuver. He lost sight of the airplane as it descended and passed about 270° of roll. His wife captured the low pass on video, but did not record the airplane climbing away from the ground or the roll maneuver. Another witness was mowing his yard when he saw the airplane traveling to the west at low altitude. It began a roll “to the south” and then “nose-dived” steeply toward the ground about 1/2 mile from his location. One of the witnesses, who was not a pilot, said he was familiar with the accident pilot and he had seen the pilot perform “barrel rolls” over property owned by a family member of the pilot. He said that the pilot was usually a couple hundred feet higher above the ground when he saw him perform those maneuvers. An on-scene examination of the wreckage was conducted by a Federal Aviation Administration (FAA) inspector. The airplane impacted an open field about 1/2 mile south of 5K1. The wreckage was located 10 to 15 ft from the initial impact point. The impact crater was 12 to 18 inches deep and the direction of travel from the impact crater to the wreckage was about 240°. The wreckage was highly impact damaged. Both wooden propeller blades were fragmented and impact-separated at the propeller hub. The landing gear were found in the retracted position. The tail section and empennage aft of the rear cockpit were almost completely severed from the fuselage and folded underneath the inverted wreckage. The control cables and associated turn buckles were in place. The flight controls could not be moved, and flight control continuity could not be verified due to the extent of impact damage. Review of the pilot’s logbook, which contained entries beginning in July 1995, revealed that the pilot began recording flights in the accident airplane in April 2017. The only entry pertaining to aerobatics instruction was contained in the first logbook entry associated with the accident airplane, an instructional flight for which the remarksincluded, “rolls.” The last flight recorded in the logbook was on April 17, 2019. The pilot’s most recent third-class medical certificate was issued on August 28, 2008, at which time he reported he was taking no medications. The pilot completed the requirements for operation under BasicMed on February 25, 2019. The Macoupin County Coroner’s Office, Brighton, Illinois, performed an autopsy of the pilot and determined the cause of death to be blunt force injuries. Toxicology testing performed for the coroner’s office detected ethanol at 0.01 grams per deciliter (gm/dL) in the pilot’s vitreous fluid. No ethanol was detected in the pilot’s blood by the FAA Forensic Sciences Laboratory. The FAA laboratory also detected the anticoagulant medication, warfarin, in liver and blood. Ethanol is a social drug commonly consumed by drinking beer, wine, or liquor. It acts as a central nervous system depressant; it impairs judgment, psychomotor functioning, and vigilance. Ethanol is water soluble, and after absorption it quickly and uniformly distributes throughout the body’s tissues and fluids. The distribution pattern parallels water content and blood supply of the tissue. Ethanol can be produced after death by microbial activity. Warfarin is a medication used to treat or prevent blood clots (thromboemboli) or prevent their complications in conditions such as atrial fibrillation or cardiac valve replacement. The medication is given to reduce the risk of sudden death, heart attacks, and strokes. Warfarin increases a person’s chance of major bleeding especially with a fall or accident; a person taking warfarin receives frequent laboratory testing to make sure the concentration balances the risks of bleeding and clotting. Warfarin is not an impairing medication, but the medication and conditions for which it is prescribed would require an observation period by the FAA.

Aircraft

Registration
N27YK
Reported as
Yakovlev YAK 52 (No Series)
Category
Airplane
Serial number
9611905
Built
1996
Airframe hours
1,137.8
Engine
Vedeneyev M14P, 360 horsepower, reciprocating
Damage
Destroyed
Flight
Personal · Part 91
Airworthiness certificate
Standard, Aerobatic
Last inspection
Annual · August 3, 2019
Airport
5K1 · Zelmer Memorial Airpark Inc

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

As NTSB recorded them. NTSB leaves out names.

Role
Pilot
Age
61
Injuries
Fatal
Certificate
Commercial
Airplane ratings
Single-engine land
Instrument ratings
Airplane
Medical
BasicMed
Last flight review
September 20, 2017
Seat
Front
Toxicology
Performed
Flight hours
3,147 total · 25 in this make and model

Weather

Conditions
Visual (VMC) · Day
Wind
360° at 8 knots
Visibility
10 statute miles
Lowest ceiling
None
Temperature
84 °F, dew point 57 °F
Altimeter
29.26 inHg

Docket · 8

The files NTSB released with the investigation on March 3, 2022, on NTSB’s docket system: statements, records, photos and specialists’ reports. 43.8 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.