# NTSB FTW91FA144: Piper PA-28RT-201T, N8144J, Midland, TX, August 9, 1991

- Type: NTSB accident investigation
- Classification: Accident · Fatal · Field investigation · Final report
- Date: August 9, 1991, 13:33 local (18:33 UTC)
- Place: Midland, TX
- Coordinates: 32.049365, -102.200706 (estimated)
- Nearby events: https://openairdocs.org/map.md?lat=32.0494&lon=-102.2007&mi=10
- Phase of flight: [Uncontrolled descent](https://openairdocs.org/ntsb-phases/650) (OpenAirDocs' grouping)
- Highest injury: Fatal
- Injuries: 1 fatal
- Status: Completed, report April 23, 1993
- Report: Approved by Office Director
- NTSB case key (mKey): 23274
- NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=FTW91FA144
- NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/23274/pdf
- Page: https://openairdocs.org/ntsb/FTW91FA144

## Probable cause

THE PILOT'S INABILITY TO CONTROL THE AIRPLANE DUE TO HIS PHYSIOLOGICAL INCAAPACITATION.  A FACTOR WAS THE PILOT'S IMPAIRMENT DUE TO THE USAGE OF PAIN MEDICATIONS.

## Sequence of events

In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf).

- In flight collision with terrain/water, descent - uncontrolled
  - aircraft control - not possible, pilot in command
  - incapacitation(other organic problem), pilot in command (cause)
  - impairment(drugs), pilot in command (contributing factor)
- Fire, standing

## Analysis

THE AIRPLANE CRASHED IN A SHALLOW UNCONTROLLED ATTITUDE ABOUT 3.5 MILES FROM ITS INTENDED DESTINATION WHILE HEADING IN THE OPPOSITE DIRECTION, DESPITE HAVING RECEIVED VECTORS THROUGH AN ARSA AND A LANDING ADVISORY FROM THE UNICOM. REVIEW OF THE ATC TAPES FROM THE DEPARTURE AND ARRIVAL SEGMENTS REVEALED THAT THE PILOT WAS IN EXTREME PHYSICAL DISTRESS UPON ARRIVAL. ANALYSIS OF THE TAPES AND THE PILOT'S MEDICAL HISTORY BY A PANEL OF FLIGHT SURGEONS INDICATED THAT THE PILOT WAS INCAPACITATED SHORTLY BEFORE IMPACT, PROBABLY DUE TO A MAJOR MEDICAL IMPAIRMENT. THE AUTOPSY REVEALED SEVERAL ARTIFACTS INDICATIVE OF SEVERAL YEARS OF HYPERTENSION AND ANKYLOSING SPONDYLITIS. HE WAS TAKING MEDICATION FOR THE CONDITIONS, HOWEVER, THE MEDICATIONS, TAKEN IN PARALLEL, COUNTERACTED THE ANTIHYPERTENSIVE MEDICINE'S EFFECT. IN ADDITION, HIS TOXICOLOGY SAMPLES REVEALED TWO PAIN MEDICATIONS, NORMALLY PRESCRIBED TO ALLEVIATE THE SIDE EFFECTS OF THE PRESCRIPTIONS BEING TAKEN FOR THE MEDICAL CONDITIONS, IN QUANTITIES ABOVE THE NORMAL THERAPEUTIC LEVELS. ONE OF THE

## Aircraft

- Registration: [N8144J](https://openairdocs.org/deregistered/N8144J-2015-04-30), registration cancelled 2015-04-30, S/N 28R-8231034, built 1982 (OpenAirDocs)
- Reported make and model: PIPER PA-28RT-201T (PA-28RT-20)
- Registry model: [Piper PA-28RT-201T](https://openairdocs.org/model/piper-pa-28rt-201t) (registry code 7102817) (OpenAirDocs)
- Registry engine: [Continental TSIO-360 series](https://openairdocs.org/engine/continental-tsio-360-series) (registry code 17019, reciprocating) (OpenAirDocs)
- Category: Airplane
- Serial number: 28R-8231034
- Airframe hours: 3808
- Engines: CONTINENTAL TSIO-360-FB1 180 horsepower reciprocating
- Damage: Destroyed
- Fire: On-Ground
- Flight: Business, Part 91
- Operator: Stevens Operating Corp.
- Registered owner: Stevens Operating Corp.
- Airworthiness certificate: Standard, Utility
- Last inspection: 100 hour, June 7, 1991, 93 hours before
- Departed: ROW, ROSWELL, NM
- Airport: MDD, Midland Airpark, runway 11, 4,380 × 150 ft, concrete

## Flight crew

As NTSB recorded them. NTSB leaves out names.

- Pilot; age 61; private; airplane ratings: single-engine land, multi-engine land; instrument ratings: airplane; medical: class 3, valid medical--w/ waivers/lim; seat: left; toxicology performed; flight hours: 4,000 total, 25 in this make and model, 3,500 as pilot in command, 24 in the last 90 days, 15 in the last 30 days, 3 in the last 24 hours

## Weather

- Conditions: Visual (VMC), Day
- Wind: 10° at 4 knots
- Visibility: 20 statute miles
- Lowest ceiling: 25,000 ft broken
- Temperature: 82 °F, dew point 64 °F
- Altimeter: 30.00 inHg
- Observed at: MAF, 6 nm away

## 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 19910809033249A](https://openairdocs.org/incident/19910809033249A), Aug 9, 1991: Piper PA28RT201T, Midland, TX, Destroyed, 1 fatal. Impacted ground after overflying destination. Voice tape analysis indicates major medical impairment.

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.

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