CEN22LA166

NTSB accident investigation · Beech B200 · Odessa, TX · March 29, 2022

Accident · Serious injuriesClass 4 · LimitedFinal report
Date
March 29, 2022, 18:45 local (23:45 UTC)
Place
Odessa, TX · Occurred in flight - during RNAV29 approach
Injuries
1 serious, 5 uninjured
Damage
No damage
Phase of flight
Approach
Aircraft
N469SLBeech B200
Defining event
Approach: Clear air turbulence encounter
Weather
Visual (VMC) · Day
Status
Completed
Report
Approved by Office Director
Investigation class
Class 4 - Basic report with no Prelim publish
NTSB office
Central Region
Parties
FAA Lubbock FSDO
FAA report
20220329004419I
Case key
104886

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 airplane’s encounter with severe clear air turbulence that was not forecasted, which resulted in a serious injury to an unrestrained passenger.

Findings · 6

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.

Turbulence: clear air turbulenceEnvironmental issues › Conditions/weather/phenomena · Effect on personnelBeech B200: 1 caseAll aircraft: 78 casesProbable cause
Equipment/furnishings: passenger compartment equipAircraft › Aircraft systems · Not used/operatedBeech B200: 1 caseAll aircraft: 24 casesProbable cause
Turbulence: clear air turbulenceEnvironmental issues › Conditions/weather/phenomena · Contributed to outcomeBeech B200: 1 caseAll aircraft: 78 casesProbable cause
Turbulence: clear air turbulenceEnvironmental issues › Conditions/weather/phenomena · Compliance w/ procedureBeech B200: 1 caseAll aircraft: 78 casesProbable cause
Turbulence: clear air turbulenceEnvironmental issues › Conditions/weather/phenomena · Awareness of conditionBeech B200: 1 caseAll aircraft: 78 casesProbable cause
Use of equip/info: use of equip/systemPersonnel issues › Task performance · PassengerBeech B200: 2 casesAll aircraft: 1,391 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 pilot reported that while descending at about 160 kts during an instrument approach in visual meteorological conditions with the autopilot engaged, and passing through 5,000 ft msl, the airplane encountered “a sudden pocket” of severe clear air turbulence for one second, resulting in the loss of about 300 ft of altitude. A passenger in the cabin, who was in the process of restraining himself when the turbulence encounter occurred, hit his head on the cabin ceiling and sustained a serious injury. The autopilot was turned off, the pilot continued with the approach, and the airplane landed at the destination airport without further incident. The airplane did not sustain any damage from the turbulence encounter. The pilot reported there were no preaccident mechanical malfunctions or failures with the airplane that would have precluded normal operation. The pilot reported that at the time of the accident, an AIRMET for moderate turbulence below 12,000 ft msl and high surface winds was active for the area. The passengers were verbally instructed by the pilot to make sure their restraint systems were fastened. The pilot activated the cabin seatbelt sign as an aural and visual warning as reinforcement.

Aircraft

Registration
N469SL
Reported as
Beech B200 (None)
Category
Airplane
Serial number
BB-1036
Built
1982
Airframe hours
9,044
Engines
Pratt & Whitney Canada PT6A-52, 850 horsepower, turbo propPratt & Whitney Canada PT6A-52, 850 horsepower, turbo prop
Damage
No damage
Flight
Business · Part 91
Operator
Integrated Pain Associates, PLLC, doing business as Integrated Pain Associates, PLLC
Registered owner
Vole Enterprises, LLC
Airworthiness certificate
Standard, Normal
Last inspection
AAIP · September 14, 2021
Departed
TPL · Temple, TX
Destination
Same as departure
Flight plan
IFR
Airport
ODO · Odessa Airport-Schlemeyer Field, runway 29, 6,200 × 100 ft, asphalt
Equipment
Stall warning system, ADS-B, Auto-pilot, Onboard weather

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
31
Injuries
None
Certificates
Commercial, Flight instructor
Airplane ratings
Single-engine land, Multi-engine land
Instrument ratings
Airplane
Medical
Class 1, Without waivers/limitations
Last flight review
May 20, 2021
Seat
Left
Restraint
4-point
Flight hours
4,000 total · 1,300 in this make and model · 3,800 as pilot in command · 100 in the last 90 days · 50 in the last 30 days · 4 in the last 24 hours

Weather

Conditions
Visual (VMC) · Day
Wind
300° at 26 knots, gusting 33
Visibility
6 statute miles
Lowest ceiling
None
Temperature
84 °F, dew point 18 °F
Altimeter
29.47 inHg
Turbulence
Severe
Observed at
KODO, 1 nm away
METAR
KODO 292353Z AUTO 30026G33KT 6SM HZ CLR 29/M08 A2947 RMK AO2 PK WND 26047/2336 SLP932 60000 T02891083 10328 20278 55018 PWINO

Docket · 4

The files NTSB released with the investigation on May 25, 2022, on NTSB’s docket system: statements, records, photos and specialists’ reports. 11.9 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.