NYC04FA136

NTSB accident investigation · Piper PA-32-300 · Leominster, MA · June 2, 2004

Accident · FatalField investigationFinal report
Date
June 1, 2004, 21:31 local (Jun 2, 2004, 01:31 UTC)
Place
Leominster, MA
Injuries
2 fatal
Damage
Destroyed
Phase of flight
Approach
Aircraft
N21072Piper PA-32-300
Weather
Instrument (IMC) · Night/dark
Status
Completed · report April 25, 2006
Report
Approved by Office Director
Parties
Lycoming Engines, FAA, Massachussets Aeronautics Commision, Piper Aircraft
FAA report
20040601011219A
Case key
59350

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 follow instrument flight procedures resulting in a collision with trees. A factor related to the accident was the low cloud ceiling, and dark night.

Sequence of events

NTSB’s coding before 2008: each occurrence and phase of flight, and the causes and factors under it. The codes are defined in NTSB’s coding manual.

In flight encounter with weatherApproach - faf/outer marker to threshold (ifr)
Lack of recent experiencePilot in command
Ifr procedure - not followedPilot in commandCause
Weather condition - low ceilingFactor
Light condition - dark nightFactor
In flight collision with objectApproach - faf/outer marker to threshold (ifr)
Object - tree(s)
Altitude/clearance - not maintainedPilot in command

Analysis

The airplane was destroyed after impacting terrain during an approach in instrument meteorological conditions. At the destination airport, weather was reported as 3 statute miles of visibility and mist, and an overcast cloud layer at 700 feet. The overcast ceiling was variable from 400 to 1,100 feet agl. The flight progressed without incident, and once in the vicinity of the destination airport, the pilot requested and was subsequently cleared for the GPS approach. No further transmissions were received from the pilot. The airplane struck trees, and came to rest in a wooded area, about 1-3/4 miles from the runway 32 threshold, and about 1/2-mile right of the extended centerline. A postcrash fire consumed the main wreckage. The elevation of the accident site was 563 feet msl. Review of the approach plate for the GPS approach revealed that the inbound course from the final approach fix, located about 5 miles prior to the airport, was 324 degrees. The minimums for the straight in approach to runway 32 were 1 statute mile of visibility, and a minimum decision altitude of 960 feet msl (624 feet agl). No procedure turn was required for the approach. Review of radar data revealed that after the airplane crossed the final approach fix, it turned right, away from the final approach course, and began tracking northbound for several seconds. The airplane then made a left turn and proceeded inbound towards the airport and tracked an approximate 300-degree course until the last radar return was received, where the airplane was about 1 mile southeast of the airport at 1,000 feet msl. The pilot had accumulated about 409 hours of total flight experience. Within the previous 6 months, he had accumulated 7 hours, of which 1.7 hours were conducted in simulated instrument conditions, and .7 hours were in actual instrument conditions. The pilot's most recent flight conducted in nighttime conditions was about 20 months prior to the accident.

Factual narrative

History of flight

On June 1, 2004, about 2131 eastern daylight time, a Piper PA-32-300, N21072, was destroyed after impacting terrain in Leominster, Massachusetts, during an approach to the Fitchburg Municipal Airport (FIT), Fitchburg, Massachusetts. The certificated private pilot and passenger were fatally injured. Night instrument meteorological conditions prevailed, and an instrument flight rules (IFR) flight plan was filed for the flight that originated from the Manchester Airport (MHT), Manchester, New Hampshire. The personal flight was conducted under 14 CFR Part 91.

According to a Federal Aviation Administration (FAA) inspector, the airplane was fueled earlier at FIT with 16.7 gallons of aviation fuel prior to departing for MHT to pick up the passenger. Upon arriving at MHT, the airplane was refueled with 14.1 gallons of aviation fuel.

The flight departed from MHT about 2109, and proceeded towards FIT.

Review of air traffic control data revealed that the pilot was instructed to "cross TOPTO at or above 2,500, cleared GPS 32 approach," which he acknowledged. No further transmissions were received from the pilot.

Review of radar data obtained from the FAA revealed that the accident airplanes flight track began at 2108:50. The airplane was at an altitude of 900 feet in the vicinity of MHT. At 2129:34, the airplane crossed abeam CLETR, the final approach fix for the GPS RWY 32 approach at FIT. At that point the airplane had been tracking a northwesterly heading approximately 320 degrees. After passing CLETR, the airplane turned right, away from the final approach course, and began tracking northbound for several seconds. At 2129:57, the airplane made a left turn and proceeded inbound towards the airport and tracked approximately a 300-degree course. The last radar return was received at 2131:44, where the airplane was about 1 mile southeast of FIT at 1,000 feet, and a ground speed of 110 knots.

The airplane came to rest on its right side, on top of a stone wall, in a wooded area, about 1-3/4 miles from the runway 32 threshold, and about 1/2-mile right of the extended centerline. A postcrash fire consumed the main wreckage.

A witness, located about 1/2-mile southwest of the accident site, heard an airplane fly overhead. The airplane noise was "louder than usual." The witness looked out her window and observed an airplane flying over the tree tops, from right to left, and "the engine sounded fine. Just loud because the plane was so low." The witness then heard a sound similar to "chopping of leaves from the tree tops," followed by silence, and a few seconds later, the sound of snapping trees.

The accident occurred during the hours of darkness, at 42 degrees, 32.430 minutes north longitude, 071 degrees, 43.18 minutes west latitude, at an elevation of 563 feet.

Personnel information

The pilot held a private pilot certificate for airplane single-engine, and instrument airplane. The pilot's most recent application for a FAA third class medical certificate was dated on December 16, 2002.

Review of the pilot's logbook, which was found in the wreckage, revealed that he had accumulated about 409 hours of total flight experience. Within the previous 6 months, he had accumulated 7 hours, of which 1.7 hours were conducted in simulated instrument conditions, and .7 hours were in actual instrument conditions. The pilot's most recent flight conducted in nighttime conditions was on November 15, 2002.

Aircraft information

The airplane's most recent annual inspection was completed on May 6, 2004, at a total aircraft time of 3,087.9 hours.

The airplane was equipped with a Garmin GPS 400 unit, and an autopilot. There were no documents recovered to confirm if the GPS unit was coupled to the autopilot.

Meteorological information

The weather reported at FIT, at 2117, included winds from 080 degrees at 4 knots; 3 statute miles of visibility; mist; an overcast cloud layer at 700 feet agl; temperature of 48 degrees Fahrenheit; dew point of 46 degrees Fahrenheit; and an altimeter setting of 29.80 inches of mercury. The overcast ceiling was variable from 400 to 1,100 feet agl.

Airport information

The airport elevation at FIT was 348 feet msl.

Aids to navigation

Review of the approach plate for the GPS Runway 32 approach at FIT revealed that the initial approach fix (IAF), TOPTO waypoint, was located 22.3 miles, outbound 211 degrees from the MHT VOR. The outbound course from TOPTO was 234 degrees, and continued 5 miles to the DELSO waypoint. The minimum altitude for the segment was 2,500 feet msl. The final approach course from DELSO was 324 degrees, and continued 5 miles to the final approach fix (FAF), CLETR waypoint. The minimum crossing altitude at CLETR was 2,000 feet msl. CLETR intersection was located 5 miles from the runway 32 threshold. The minimums for the straight in approach to runway 32 were 1 statute mile of visibility, and a minimum decision altitude of 960 feet msl (624 feet agl). No procedure turn was required for the approach.

Wreckage and impact information

Examination of the accident site on June 2, 2004, revealed terrain that consisted of evergreen and hardwood trees reaching a height of about 80 feet. The foliage surrounding the accident site was wilted, consistent with being sprayed with aviation fuel and exposure to heat. The wreckage path was about 280 feet in length, and was oriented on a 050-degree heading, with the main fuselage coming to rest on a 055-degree heading.

The first tree strike area was located about 250 feet prior to the main fuselage. Surrounding the tree strike area, were branches of varying diameters that were cut at 45-degree angles and displayed black and red paint transfer. Along the wreckage path were wing skin sections from the left wing and the empennage assembly.

All flight control surfaces were accounted for at the accident site.

When the right side of the stabilator was examined, a 3-inch deep u-shaped dent was present on the leading edge. Tree bark was observed in the dent compression mark.

The 3-bladed propeller assembly was separated from the engine. All three blades broke loose from the hub assembly, and were located about 30-40 feet beyond the main wreckage. The blades displayed s-bending and leading edge nicks. One blade exhibited chord-wise scratching. The propeller blades were painted black, with red and white stripes painted on the tips.

Examination of the cockpit area revealed that the fuel selector was in the "left" tank position, and that the flap handle was in retracted position.

The pilot's airspeed indicator was recovered, but sustained impact damage. The airspeed indicator displayed a reading of 0 knots. The altimeter displayed a reading of 495 feet. The Kollsman window displayed an altimeter setting of 29.78 inches of mercury. The attitude indicator and directional gyro were disassembled. Evidence of rotational scoring was observed on the inside gyro rotor housings of both instruments.

The remaining primary flight instruments and engine instruments; the throttle, mixture, and propeller controls were destroyed.

The engine was recovered from the accident site and examined on June 3, 2004. The crankshaft was rotated through the accessory drive section. Thumb compression and valve train continuity was confirmed to the number 3 through number 6 cylinders. The number 1 cylinder head was separated from its barrel, and disintegrated. The number 2 cylinder intake and exhaust push rods were bent, which restricted the movement of the rocker arms.

With the exception of the number 1 cylinder, the top and bottom spark plugs of all remaining cylinder heads were removed; their electrodes were intact and dark gray in color. When the left magneto was removed from the engine case and rotated by hand, it produced spark from all leads. The right magneto was found separated from the e

Aircraft

Registration
N21072
Reported as
Piper PA-32-300
Category
Airplane
Serial number
32-7840183
Airframe hours
3,089
Engine
Lycoming IO-540, 300 horsepower, reciprocating
Damage
Destroyed
Fire
On-Ground
Flight
Personal · Part 91
Registered owner
James P. Normandin
Airworthiness certificate
Standard, Normal
Last inspection
Annual · May 1, 2004
Departed
MHT · Manchester, NH
Destination
FIT · Fitchburg, MA
Flight plan
IFR
Airport
FIT · Fitchburg Municipal Airport, runway 32

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
47
Injuries
Fatal
Certificate
Private
Airplane ratings
Single-engine land
Instrument ratings
Airplane
Medical
Class 3, Without waivers/limitations
Last flight review
December 1, 2002
Seat
Left
Toxicology
Performed
Flight hours
400 total · 4 in the last 90 days · 1 in the last 30 days · 1 in the last 24 hours

Weather

Conditions
Instrument (IMC) · Night/dark
Wind
80° at 4 knots
Visibility
3 statute miles
Lowest ceiling
700 ft overcast
Temperature
48 °F, dew point 46 °F
Altimeter
29.79 inHg
Observed at
FIT, 2 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.

Other investigations on N21072 · 1

Matched to the same aircraft by N-number and date.