# NTSB ERA21FA355: American Champion 8KCAB, N390PE, Rhine, GA, September 12, 2021 - Type: NTSB accident investigation - Classification: Accident · Fatal · Class 3 · Field · Final report - Date: September 12, 2021, 09:30 local (13:30 UTC) - Place: Rhine, GA · Airplane came to rest in the tree line of a open field. - Coordinates: 32.000466, -83.179821 (estimated) - Nearby events: https://openairdocs.org/map.md?lat=32.0005&lon=-83.1798&mi=10 - Phase of flight: [Maneuvering](https://openairdocs.org/ntsb-phases/450) (OpenAirDocs' grouping) - Defining event: [Maneuvering-low-alt flying: Low altitude operation/event](https://openairdocs.org/ntsb-events/220) - Highest injury: Fatal - Injuries: 1 fatal - Status: Completed - Report: Approved by Office Director - Investigation class: Class 3 - NTSB office: Eastern Region Aviation - Parties: FAA/FSDO, Lycoming Engines - NTSB case key (mKey): 103839 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=ERA21FA355 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/103839/pdf - NTSB docket: https://data.ntsb.gov/Docket?ProjectID=103839 - Page: https://openairdocs.org/ntsb/ERA21FA355 ## Probable cause A collision with trees during a low-altitude aerobatic maneuver for unknown reasons. ## Findings NTSB's coded findings; those marked are part of the probable cause. - [Action: unnecessary action](https://openairdocs.org/ntsb-findings/02041045): Personnel issues › Action/decision · Pilot; cases with it: [American Champion 8KCAB, 1 case](https://openairdocs.org/ntsb-findings/02041045/cases.md?model=2121000), [All aircraft, 52 cases](https://openairdocs.org/ntsb-findings/02041045/cases.md) - [Not determined](https://openairdocs.org/ntsb-findings/05000000): Not determined › Not determined · Unknown/Not determined; cases with it: [American Champion 8KCAB, 3 cases](https://openairdocs.org/ntsb-findings/05000000/cases.md?model=2121000), [All aircraft, 2,247 cases](https://openairdocs.org/ntsb-findings/05000000/cases.md) - [Performance/control parameters: altitude](https://openairdocs.org/ntsb-findings/01062012): Aircraft › Aircraft oper/perf/capability · Not attained/maintained; cases with it: [American Champion 8KCAB, 3 cases](https://openairdocs.org/ntsb-findings/01062012/cases.md?model=2121000), [All aircraft, 1,310 cases](https://openairdocs.org/ntsb-findings/01062012/cases.md) ## Sequence of events The events NTSB coded, in order, by phase of flight. The defining event best describes what happened. - [Maneuvering-low-alt flying: Low altitude operation/event](https://openairdocs.org/ntsb-events/220) (defining event); cases with it: [American Champion 8KCAB, 3 cases](https://openairdocs.org/ntsb-events/220/sequence.md?model=2121000), [All aircraft, 780 cases](https://openairdocs.org/ntsb-events/220/sequence.md) ## Analysis A witness, who was a friend of the pilot, stated the pilot had mentioned feeling dizzy and nauseous while performing aerobatics during a flight earlier on the day of the accident and landed due to vomiting. Later that same day, the pilot departed his private airstrip and headed to a nearby field where the witness was located with the intention of searching for birds. While the witness was in the field, the pilot flew past him and circled for a second pass. During the second pass, the pilot descended below the tree line and initiated an aileron roll. However, the pilot abruptly stopped the maneuver halfway through and the aircraft flew into the trees at full engine power. The airplane sustained impact damage to the fuselage, while the instrument panel and cockpit were destroyed. Postaccident examination of the flight control system and engine did not reveal any anomalies that would have precluded normal operation. To what degree the pilot’s symptoms of dizziness and nausea from earlier in the day had resolved, persisted, or progressed at the time of the accident flight is unknown. If the pilot was still feeling unwell at the time of the flight, this may have impaired his ability to execute the aileron roll. ## Factual narrative On September 12, 2021, about 0930 eastern daylight time, an American Champion Aircraft 8KCAB, N390PE, was substantially damaged when it was involved in an accident near Rhine, Georgia. The commercial pilot was fatally injured. The airplane was operated as a Title 14 Code of Federal Regulations Part 91 personal flight. A witness, who was a friend of the pilot, reported that the pilot told him that he felt dizzy, nauseous, and vomited while practicing aerobatics earlier in the day before the accident flight. The pilot landed at a private airstrip and subsequently departed to fly to a nearby field, where the witness was located, to look for birds. While the witness was in the field, the pilot "buzzed" him and flew around for a second pass. During the second pass, the pilot descended the airplane below the tree line and started an aileron roll. However, about halfway through the roll, the pilot abruptly stopped the maneuver, and the airplane flew straight into the trees at full engine power. The airplane came to rest oriented on a magnetic heading of 220°, and all major components of the airplane were located at the accident site. The fuselage, from the firewall to the empennage, exhibited accordion crush and impact damage. The instrument panel and cockpit were destroyed due to the impact. Both wings had separated from the fuselage, while the horizontal stabilizers and vertical stabilizer remained attached to the empennage displaying damage consistent with the impact. Flight control continuity was established from the flight control surfaces to the cockpit controls. The propeller was splintered and broken. Fresh cuts, which were consistent with propeller slash marks, were found on several trees at the accident site. The examination of flight controls and engine revealed no mechanical malfunctions or failures that would have precluded normal operation. The Georgia Bureau of Investigation Division of Forensic Sciences performed the pilot’s autopsy at the request of the Dodge County Coroner. According to the autopsy report, the cause of death was multiple blunt impact injuries, and the manner of death was accident. The Federal Aviation Administration Forensic Sciences Laboratory performed toxicological testing of specimens from the pilot, identifying only tadalafil, in cavity blood and liver. Tadalafil, sometimes marketed as Cialis, is a prescription medication commonly used to treat erectile dysfunction. It may also be used to treat symptoms of a large prostate, or to reduce high blood pressure in the lungs. According to reviewed primary care records, the pilot visited his primary care provider 5 days before the accident, on September 7, 2021, for sore throat and fever. No complaints of cough, nausea, vomiting, dizziness, or other symptoms apart from sore throat and fever were noted. ## Aircraft - Registration: [N390PE](https://openairdocs.org/aircraft/N390PE), registered now, S/N 1156-2015, built 2015 (OpenAirDocs) - Reported make and model: AMERICAN CHAMPION AIRCRAFT 8KCAB - Registry model: [American Champion 8KCAB](https://openairdocs.org/model/american-champion-8kcab) (registry code 2121000) (OpenAirDocs) - Registry engine: [Lycoming AEIO-390-A1B6](https://openairdocs.org/engine/lycoming-aeio-390-a1b6) (registry code 42409, reciprocating) (OpenAirDocs) - Category: Airplane - Serial number: 1156-2015 - Year built: 2015 - Airframe hours: 106 - Engines: Lycoming AEIO-390-A1B6 200 horsepower reciprocating - Damage: Substantial damage - Flight: Personal, Part 91 - Airworthiness certificate: Standard, Aerobatic; Standard, Normal - Last inspection: Annual, January 15, 2021, 106 hours before - Destination: Same as departure - Equipment: Unknown ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 30; injuries: fatal; commercial; airplane ratings: multi-engine land, single-engine land; instrument ratings: airplane; medical: class 2, without waivers/limitations; seat: left; restraint: 4-point; toxicology performed; flight hours: 2,700 total, 150 in this make and model ## Weather - Conditions: Visual (VMC), Day - Wind: calm - Visibility: 10 statute miles - Lowest ceiling: none - Temperature: 66 °F, dew point 64 °F - Altimeter: 30.23 inHg - Observed at: EZM, 16 nm away - METAR: METAR KEZM 120135Z AUTO 00000KT 10SM CLR 19/18 A3023 RMK AO2 T01940181 ## FAA reports on this event (1) The FAA's own accident and incident reports, matched to the aircraft by N-number and date (OpenAirDocs). - [Accident 20210912015639A](https://openairdocs.org/incident/20210912015639A), Sep 12, 2021: American Champion Aircraft 8KCAB, Rhine, GA, Destroyed, 1 fatal. On September 12, 2021, at approximately 1930 eastern daylight savings time, a 2015 American Champion Aircraft corporation, model 8KCAB, with registration… ## Docket (8 files) The files NTSB released with the investigation on August 30, 2023, on NTSB's docket system: https://data.ntsb.gov/Docket?ProjectID=103839. 63.7 MB in all. - Memorandum for record- pilot's parents statement (item 1, PDF, 1 page, 99 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=15892725&FileExtension=pdf&FileName=Memorandum%20Of%20Record%20discussion%20with%20pilot%27s%20parents%20FA355-Rel.pdf - Memorandum for record - witness (item 2, PDF, 1 page, 98 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=15891925&FileExtension=pdf&FileName=Memorandum%20Of%20Record%20witness%20on%20scene%20FA355-Rel.pdf - Aircraft wreckage examination (item 3, PDF, 2 pages, 198 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=15890514&FileExtension=pdf&FileName=Wreckage%20Examination%20FA355-Rel.pdf - Maintenance records (item 4, PDF, 18 pages, 59.7 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=15898591&FileExtension=pdf&FileName=Maintenance%20Records%201_Redacted-Rel.pdf - Toxicological report (item 5, PDF, 1 page, 162 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=15890524&FileExtension=pdf&FileName=Tox%20FA355_Redacted-Rel.pdf - Autopsy memorandum for record (item 6, PDF, 1 page, 169 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=15899691&FileExtension=pdf&FileName=Autopsy%20MFR%20FA355-Rel.pdf - Investigative photos (item 7, PDF, 4 pages, 3.1 MB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=15890803&FileExtension=pdf&FileName=Investigative%20Photos%20FA355-Rel.pdf - Release of aircraft wreckage, NTSB form 6120.15 (item 8, PDF, 2 pages, 155 KB): https://data.ntsb.gov/Docket/Document/docBLOB?ID=15885152&FileExtension=pdf&FileName=Wreckage%20Release%20N390PE%20(002)_Redacted-Rel.pdf From the NTSB's public API. Aircraft are matched to registry aircraft by N-number and event date, checked against the reported serial number, make and model; the registry's history has gaps, so older matches can be wrong. Compare the reported make and model. --- OpenAirDocs.org is an independent research project of [Contrail Labs](https://contraillabs.com/). It is not affiliated with the FAA or the NTSB. Source documents are U.S. government works in the public domain.