ERA15LA114

NTSB accident investigation · Cessna 150 · Fernandina Beach, FL · January 25, 2015

Accident · Serious injuriesLimited investigationFinal report
Date
January 25, 2015, 14:30 local (19:30 UTC)
Place
Fernandina Beach, FL
Injuries
1 serious
Damage
Substantial damage
Phase of flight
Approach
Aircraft
N10616Cessna 150
Defining event
Approach-VFR pattern final: Controlled flight into terr/obj (CFIT)
Weather
Visual (VMC) · Day
Status
Completed · report September 6, 2017
Report
Approved by Office Director
NTSB office
Eastern Region Aviation
Parties
FAA/FSDO
FAA report
20150125002989A
Case key
90646

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 physical impairment due to intense pain, which resulted in his failure to maintain airplane control.

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.

Impairment/incapacitationPersonnel issues › Physical · PilotCessna 150L: 1 caseAll aircraft: 40 casesProbable cause
Use of equip/info: aircraft controlPersonnel issues › Task performance · PilotCessna 150L: 26 casesAll aircraft: 9,295 casesProbable cause
Performance/control parametersAircraft › Aircraft oper/perf/capability · Not attained/maintainedCessna 150L: 9 casesAll aircraft: 1,269 casesProbable cause
Object/animal/substanceEnvironmental issues › Physical environment · Contributed to outcomeCessna 150L: 2 casesAll aircraft: 224 cases

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 commercial pilot was returning to his home airport during a personal cross-country flight. The pilot reported that, during the flight, he experienced a pain in his right shoulder, followed by intense pain in his left shoulder. Although he had experienced pain previously in his right shoulder during long car rides, he had never experienced pain in his left shoulder before. Due to the intense pain, the pilot contacted air traffic control, declared an emergency, and requested that an ambulance wait for his arrival. He attempted to line up to the runway for landing but was unable to do so. The airplane impacted a berm and nosed over about 1/2 mile from the airport. The pilot could not recall any other details after that time. The pilot extricated himself from the inverted airplane and was subsequently taken to a hospital. A postaccident examination of the airplane revealed no preimpact mechanical failures or malfunctions that would have precluded normal operation. During the pilot's postaccident hospital evaluation, no definitive reason for the pain was found. However, considering the pilot's recollection, the intense pain he experienced likely impaired his ability to safely control the airplane and resulted in the accident.

Factual narrative

On January 25, 2015, about 1430 eastern standard time, a Cessna 150L, N10616, was substantially damaged when it impacted terrain while on approach to Fernandina Beach Municipal Airport (FHB), Fernandina Beach, Florida. The commercial pilot sustained serious injuries. Visual meteorological conditions prevailed and no flight plan was filed for the personal flight, which departed Lakeland Linder Regional Airport (LAL), Lakeland, Florida, at an unknown time, destined for FHB. The flight was conducted under the provisions of 14 Code of Federal Regulations Part 91.During a postaccident interview, the pilot reported that, as was his usual procedure, he flew along the west boundary of the Jacksonville Class B airspace until he was due west of his home airport. At which time he turned the airplane east, flew along the north boundary of the Class B airspace, directly to his home base airport. The distance between the departure and destination airports was about 160 nautical miles. Shortly after making the turn to the east, he experienced a "pain" in his right shoulder, which he experienced before when on a "long" car ride. After adjusting his seating position, he reported that the pain was tolerable. About 20 miles from his home base airport an "intense pain" began in his left shoulder, which was something he had not experienced previously. He contacted air traffic control, declared an emergency, and requested that an ambulance wait for him at the airport due to the intense pain. He attempted to line up for runway 9; however, he stated that he was unable to do so. He could not recall any details after that time. According to a Federal Aviation Administration (FAA) inspector that responded to the accident location, the airplane impacted a berm on the east edge of a retention pond, about 1/2 mile from the approach end of runway 13. The airplane left a ground scar about 200 ft in length; subsequently, the nose landing gear separated and the airplane nosed over coming to rest inverted on the top of the berm. Photographs provided by the FAA inspector revealed that the fuselage was buckled, the outboard approximate 4 ft of the left wing was impact damaged, the top of the rudder was damaged, and forward of the firewall was bent. The propeller blades exhibited blade tip curling beginning about mid-span of the blades. There were no preimpact malfunctions or abnormalities noted with the airplane, that would have precluded normal operation. Aircraft recovery personnel reported that about 15 gallons of fuel was removed from the fuel tanks and that the fuel tanks were unbreached. Aircraft maintenance records provided by the mechanic indicated that the airplane's most recent annual inspection was recorded on January 22, 2014. At the time of the inspection the airplane had 8,891.2 total hours time in service. The airplane was powered by a Continental O-200-A engine. According to the FAA, the 90-year-old pilot's most recent medical certification examination occurred onMay 15, 2014, and included the limitation for corrective lenses for both near and distant vision. The certificate was also marked "not valid for any class after May 31, 2015." He had received a special issuance medical certificate due to diabetes since 2003. At the time of the medical examination, the pilot reported 25,265.5 total hours of flight experience. Hospital records indicated that the pilot extricated himself from the airplane after the accident. He had been admitted to the hospital for about 3 weeks, due to injuries sustained during the accident. However, postaccident hospital evaluation found no definitive reason for the reported intense pain.

Aircraft

Registration
N10616
Reported as
Cessna 150 (L)
Category
Airplane
Serial number
15074926
Built
1973
Airframe hours
8,891.2
Engine
Cont Motor O-200-A, 100 horsepower, reciprocating
Damage
Substantial damage
Flight
Personal · Part 91
Airworthiness certificate
Standard, Normal
Last inspection
Annual · January 22, 2014
Departed
LAL · Lakeland, FL
Destination
FHB · Fernandina Beach, FL
Airport
FHB · Fernandina Beach Muni, runway 13, 5,152 × 100 ft, asphalt
Equipment
Unknown

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
90
Injuries
Serious
Certificate
Commercial
Airplane ratings
Multi-engine land, Single-engine land
Instrument ratings
Airplane
Medical
Class 2, With waivers/limitations
Seat
Left
Restraint
3-point
Flight hours
25,265 total

Weather

Conditions
Visual (VMC) · Day
Wind
220° at 7 knots
Visibility
10 statute miles
Lowest ceiling
None
Temperature
63 °F, dew point 34 °F
Altimeter
29.94 inHg
Observed at
KNRB, 13 nm away

Docket · 10

The files NTSB released with the investigation on August 7, 2017, on NTSB’s docket system: statements, records, photos and specialists’ reports. 2.5 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.