ERA17FA123

NTSB accident investigation · Jordan Bruce C Pitts S2E · Apex, NC · March 8, 2017

Accident · FatalField investigationFinal report
Date
March 8, 2017, 15:37 local (20:37 UTC)
Place
Apex, NC
Injuries
1 fatal
Damage
Substantial damage
Phase of flight
Approach
Aircraft
N30BJJordan Bruce C Pitts S2E
Defining event
Approach-VFR pattern final: Loss of control in flight
Weather
Visual (VMC) · Day
Status
Completed · report April 17, 2018
Report
Approved by Office Director
NTSB office
Eastern Region Aviation
Parties
FAA/FSDO, Lycoming Engines
FAA report
20170308005429A
Case key
94838

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

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Probable cause

The pilot's failure to maintain airplane control during the final approach to the runway in gusting tailwind conditions, which resulted in the airplane exceeding its critical angle of attack and an aerodynamic stall.

Findings · 5

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.

Wind: tailwindEnvironmental issues › Conditions/weather/phenomena · Effect on operationJordan Bruce C PITTS S2E: 1 caseAll aircraft: 594 casesProbable cause
Wind: gustsEnvironmental issues › Conditions/weather/phenomena · Effect on operationJordan Bruce C PITTS S2E: 1 caseAll aircraft: 1,199 casesProbable cause
Performance/control parametersAircraft › Aircraft oper/perf/capability · Not attained/maintainedJordan Bruce C PITTS S2E: 1 caseAll aircraft: 1,269 casesProbable cause
Performance/control parameters: angle of attackAircraft › Aircraft oper/perf/capability · Not attained/maintainedJordan Bruce C PITTS S2E: 1 caseAll aircraft: 990 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 was returning to the airport from a local personal flight in the airplane. The airplane approached runway 9 at an angle before rolling inverted, descending, and impacting terrain, consistent with an aerodynamic stall. A review of weather conditions revealed that, on final approach, the airplane likely experienced a tailwind of about 9 knots with wind gusts as high as 20 knots. Pilots familiar with the airport reported that, due to the slope of the runway, pilots preferred to land on runway 9 unless there was a tailwind of more than 10 knots. Postaccident examination of the airplane and engine revealed no evidence of mechanical malfunctions or anomalies that would have precluded normal operations. It is likely that, while maneuvering on final approach to the runway with a gusting tailwind, the pilot failed to maintain control of the airplane, which resulted in the exceedance of the airplane's critical angle of attack and an aerodynamic stall.

Factual narrative

HISTORY OF FLIGHT On March 8, 2017, at 1537 eastern standard time, an experimental amateur-built Pitts S2E, N30BJ, was substantially damaged after it impacted trees and terrain while on approach to Cox Airport (NC81), Apex, North Carolina. The commercial pilot was fatally injured. The airplane was registered to and operated by the pilot under the provisions of Title 14 Code of Federal Regulations Part 91. Visual meteorological conditions prevailed, and no flight plan was filed for the personal local flight, which originated about 1500. According to witnesses, the airplane was descending on approach to runway 9 at NC81. One witness reported that, when the airplane passed overhead, the engine "sounded like it was running perfectly." Another witness reported seeing the airplane approaching the runway at an angle before the airplane went out of her line of sight. A third witness stated that the airplane "rolled inverted" before it impacted a field about 300 feet short of the threshold of runway 9. Several witnesses reported that they heard two "booms." PERSONNEL INFORMATION According to Federal Aviation Administration (FAA) records, the pilot held a commercial pilot certificate with ratings for airplane single-engine land and instrument airplane. The pilot was issued an FAA third-class medical certificate on October 17, 2016. According to the pilot's logbook, he had accumulated a total of 1,933.2 hours of flight time. In the previous year, he had accumulated 9.4 hours of flight time, all of which were in the accident airplane. AIRCRAFT INFORMATION According to FAA records, the two-place biplane was issued an airworthiness certificate on January 23, 2009. It was equipped with a 190-horsepower Lycoming HIO-360 series engine that drove a two-bladed Hartzell constant speed propeller. According to the airplane's maintenance logbooks, a condition inspection was completed on October 17, 2016, at a total time of 92.7 hours. Since that time, the pilot had flown the airplane for a total of 3.7 hours. METEOROLOGICAL INFORMATION At 1537, Raleigh-Durham International Airport (RDU), Raleigh, North Carolina, located about 9 miles north of the accident location, reported the 2-minute average wind from 292° at 9 knots and the 5-second maximum average wind from 297° at 15 knots. The observations from surrounding airports around the accident time indicated gusty surface wind conditions from the west through north. Wind gusts as high as 20 knots from 287° were observed as close as 12 minutes before the accident time at RDU. The model sounding created for the accident site at 1500 indicated a surface wind from 295° at 10 knots with the wind remaining northwesterly through 10,000 ft. The wind increased in speed to 15 knots by 2,500 ft and to 30 knots by 9,000 ft. Light low-level wind shear was possible between the surface and 700 ft, and light to moderate clear-air turbulence was possible above 5,000 ft.. AERODROME INFORMATION NC81 was a private airport located about 1mile north of Apex, North Carolina, and it did not have an operating control tower. The airport was equipped with a turf runway designated as 9/27, which was 2,450 ft long by 75 ft wide. The airport elevation was 455 ft above mean sea level. According to local pilots familiar with NC81, because of the sloped runway, some pilots would land with up to a 10-knot tailwind on runway 9 before they would decide to land into the wind on runway 27. The pilot's son stated that the pilot used runway 9 about 90% of the time, and, only used runway 27 if there was a strong wind. WRECKAGE AND IMPACT INFORMATION The airplane impacted a pine tree before impacting the ground and came to rest, partially inverted, on the left wing. The fuselage was oriented on a 150° heading, and a ground scar was located about 15 ft before the main wreckage. A debris field began some distance beyond the pine tree and extended about 240 ft long on a 90° heading Flight control continuity was confirmed from the cockpit to all the flight control surfaces. The lower left wing was bent aft, and the outboard section was separated and scattered along the debris path. A section of the lower left wingtip was located in the vicinity of the initial tree strike. The upper left wing was partially separated. The right wings remained attached to the fuselage and were bent forward. The empennage remained attached to the fuselage. The right horizontal stabilizer and right elevator were undamaged. The vertical stabilizer and rudder remained attached to the empennage, incurred skin damage, and were slightly bent. The left horizontal stabilizer and left elevator remained attached to the empennage, and the outboard sections of both the left horizontal stabilizer and left elevator were bent in a positive direction. The propeller remained attached to the engine, and both blades exhibited chordwise scratching. In addition, one blade displayed leading edge gouging, and the other blade exhibited tip tearing and blade curling. The engine remained attached to the airframe and was removed to facilitate further examination. The top cowling was removed, and several pine needles were noted on top of the cylinders, consistent in appearance with those found on the pine tree at the beginning of the wreckage path. The bottom section of the cowling was crushed upward by impact. Engine crankshaft continuity was confirmed from the propeller flange to the accessory section of the engine. All cylinders remained attached to the crankcase, and thumb compression and suction were observed on all cylinders when the crankshaft was rotated by hand. The rocker box covers were removed, and no anomalies were noted with the valve springs and rocker arms. Valve train continuity was confirmed when the crankshaft was rotated through 360°. The throttle and mixture control cables remained attached to the controls in the cockpit but were cut to facilitate examination. Fuel was noted throughout the entire fuel system. MEDICAL ANDPATHOLOGICAL INFORMATION The North Carolina Department of Health and Human Services, Office of the Chief Medical Examiner, Raleigh, North Carolina, performed the autopsy on the pilot. The autopsy report indicated that the pilot's cause of death was multiple blunt force injuries. The FAA's Bioaeronautical Sciences Research Laboratory, Oklahoma City, Oklahoma, performed toxicological testing of the pilot. Fluid and tissue specimens from the pilot tested negative for carbon monoxide and ethanol. Desmethylsildenafil, sildenafil, and valsartan were detected in the blood and urine. These medications are non-impairing.

Aircraft

Registration
N30BJ
Reported as
Jordan Bruce C Pitts S2E (E)
Category
Airplane, amateur-built
Serial number
BJ-3
Built
2009
Airframe hours
96.4
Engine
Lycoming HIO-360-D1A, 190 horsepower, reciprocating
Damage
Substantial damage
Flight
Personal · Part 91
Airworthiness certificate
Special, Experimental (Special)
Last inspection
Condition · October 17, 2016 · 4 hours before
Departed
NC81 · Apex, NC
Destination
NC81 · Apex, NC
Airport
NC81 · Cox Airport, runway 09, 2,450 × 75 ft, grass/turf
Equipment
None

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
80
Injuries
Fatal
Certificate
Commercial
Airplane ratings
Single-engine land
Instrument ratings
Airplane
Medical
Class 3, With waivers/limitations
Last flight review
October 15, 2016
Seat
Rear
Restraint
5-point
Toxicology
Performed
Flight hours
1,933.1 total · 96.4 in this make and model · 1,678.6 as pilot in command · 2.7 in the last 90 days

Weather

Conditions
Visual (VMC) · Day
Wind
292° at 9 knots
Visibility
10 statute miles
Lowest ceiling
None
Temperature
70 °F, dew point 16 °F
Altimeter
30.18 inHg
Observed at
RDU, 9 nm away

Docket · 8

The files NTSB released with the investigation on March 29, 2018, on NTSB’s docket system: statements, records, photos and specialists’ reports. 19.0 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.