# NTSB NYC92FA047: Piper PA-23-235, N4959P, Fall River, MA, December 14, 1991 - Type: NTSB accident investigation - Classification: Accident · Fatal · Field investigation · Final report - Date: December 14, 1991, 17:45 local (22:45 UTC) - Place: Fall River, MA - Location: 41.7015° N, 71.1550° W: Placed by OpenAirDocs: center of Fall River, MA, within about 6 miles (OpenAirDocs) - Nearby events: https://openairdocs.org/map.md?lat=41.7015&lon=-71.1550&mi=10 - Phase of flight: [Approach](https://openairdocs.org/ntsb-phases/500) (OpenAirDocs' grouping) - Highest injury: Fatal - Injuries: 1 fatal - Status: Completed, report April 27, 1993 - Report: Approved by Office Director - NTSB case key (mKey): 37046 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=NYC92FA047 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/37046/pdf - Page: https://openairdocs.org/ntsb/NYC92FA047 ## Probable cause THE PILOT DID NOT FOLLOW IFR PROCEEDURES AND WAS MANUVERING AT TOO LOW AN ALTITUDE TO REMAIN CLEAR OF THE TERRAIN. FACTORS IN THE ACCIDENT WERE; FATIGUE, FOG AND NO VISUAL GROUND CLUES. ## Sequence of events In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf). - In flight encounter with weather, missed approach (ifr) - weather condition - fog (contributing factor) - missed approach - attempted, pilot in command - fatigue, pilot in command (contributing factor) - light condition - dark night (contributing factor) - ifr procedure - not followed, pilot in command (cause) - maneuver - improper, pilot in command (cause) - proper altitude - not maintained, pilot in command (cause) - In flight collision with terrain/water, missed approach (ifr) - terrain condition - ground ## Analysis WHILE ON AN NDB APPROACH, THE PILOT CANCELLED HIS IFR FLIGHT PLAN WHEN HE HAD THE FIELD IN SIGHT. SHORTLY AFTER RADAR SERVICE WAS TERMINATED THE PILOT REESTABLISHED RADIO CONTACT WITH ATC AND SAID HE LOST SIGHT OF THE AIRPORT. ATC INSTRUCTED THE PILOT TO CLIMB TO 2000 FEET, BUT HE DID NOT REPLY. THE LAST RADAR RETURN DEPICTED THE AIRPLANE TURNING TO THE LEFT (NORTHEAST), THE PUBLISHED MISSED APPROACH IS A CLIMBING RIGHT TURN TO AN ALTITUDE OF 1900 FEET MSL. THE AIRPLANE IMPACTED TREES ABOUT 1 1/2 MILE NORTHEAST OF THE AIRPORT. WHEN THE PILOT STARTED THE APPROACH HE HAD BEEN FLYING FOR APPROXIMATELY 5 HOUR AND 40 MINUTES, NON STOP FROM KENTUCKY. THE FLIGHT HAD BEEN FLOWN ALMOST TOTALLY IN IMC CONDITIONS, MODERATE TO SEVERE TURBULENCE, AND RIME ICE. THE APPROACH WAS ATTEMPTED DURING THE HOURS OF DARKNESS WITH LOW VISIBILITY AND NO GROUND REFERENCES. ## Aircraft - Registration: [N4959P](https://openairdocs.org/deregistered/N4959P-1992-01-30), registration cancelled 1992-01-30, S/N 27560 (OpenAirDocs) - Reported make and model: PIPER PA-23-235 - Registry model: [Piper PA-23-235](https://openairdocs.org/model/piper-pa-23-235) (registry code 7102306) (OpenAirDocs) - Category: Airplane - Serial number: 27-560 - Engines: LYCOMING O-540-B1A5 235 horsepower reciprocating - Damage: Destroyed - Fire: On-Ground - Flight: Personal, Part 91 - Operator: Milton Novotny, doing business as Novopak Inc. - Registered owner: Milton Novotny - Airworthiness certificate: Standard, Normal - Last inspection: Unknown, January 2, 2000 - Departed: BWG, BOWLING GREEN, KY - Flight plan: IFR - Airport: FLR, Fall River Municipal, runway 24, 3,948 × 150 ft, asphalt ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 57; private; airplane ratings: multi-engine land, single-engine land; instrument ratings: airplane; medical: class 3, valid medical--w/ waivers/lim; seat: left; toxicology performed; flight hours: 2,830 total, 1,900 in this make and model, 2,577 as pilot in command, 54 in the last 90 days, 22 in the last 30 days ## Weather - Conditions: Instrument (IMC), Night/dark - Wind: 220° at 16 knots - Visibility: 4 statute miles - Lowest ceiling: 500 ft overcast - Temperature: 55 °F, dew point 55 °F - Altimeter: 29.00 inHg - Observed at: EWB, 10 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 19911214056319A](https://openairdocs.org/incident/19911214056319A), Dec 14, 1991: Piper PA23235, Fall River, MA, Destroyed, 1 fatal. Reported field insight. Cancelled then lost it. Missed. Climbed out. Turned wrong way. Lost control. Struck trees. ## Other investigations on N4959P (1) 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. - [NTSB MIA72DKJ45](https://openairdocs.org/ntsb/MIA72DKJ45), Mar 16, 1972: Piper PA-23 (N4959P), Decatur, AL, substantial damage 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.