# NTSB SEA05LA128: Ellsberg One Design, N555TE, Madras, OR, June 25, 2005 - Type: NTSB accident investigation - Classification: Accident · Fatal · Limited investigation · Final report - Date: June 25, 2005, 13:33 local (20:33 UTC) - Place: Madras, OR - Coordinates: 44.66611, -121.163055 - Nearby events: https://openairdocs.org/map.md?lat=44.6661&lon=-121.1631&mi=10 - Phase of flight: [Maneuvering](https://openairdocs.org/ntsb-phases/450) (OpenAirDocs' grouping) - Highest injury: Fatal - Injuries: 1 fatal - Status: Completed, report March 28, 2006 - Report: Approved by Office Director - Parties: FAA FSDO - NTSB case key (mKey): 61800 - NTSB case page: https://web.ntsb.gov/investigations/?ntsbnumber=SEA05LA128 - NTSB report (PDF, downloads): https://data.ntsb.gov/carol-repgen/api/Aviation/ReportMain/GenerateNewestReport/61800/pdf - Page: https://openairdocs.org/ntsb/SEA05LA128 ## Probable cause The pilot's failure to maintain altitude/clearance from terrain while performing aerobatics which resulted in a collision with the ground. ## Sequence of events In NTSB's coding before 2008 (https://www.ntsb.gov/GILS/Documents/codman.pdf). - In flight collision with terrain/water, maneuvering - aerobatics - performed, pilot in command - terrain condition - ground - altitude/clearance - not maintained, pilot in command (cause) ## Analysis The pilot was practicing aerobatic maneuvers in the single-seat experimental airplane when the accident occurred. Witnesses observed the pilot make a low pass down the runway and then enter a vertical ascent. The airplane climbed to about 1,500 feet agl, at which point the pilot placed the airplane in a flat spin. After completing 4 to 5 rotations, the pilot recovered from the spin. The witnesses estimated that after the spin recovery, the airplane was at an altitude between 70 and 200 feet agl. The airplane continued to descend, impacted the ground, exploded and was consumed by fire. An on scene examination of the wreckage by an FAA inspector found no evidence of any pre-impact mechanical discrepancies. ## Factual narrative On June 25, 2005, about 1333 Pacific daylight time, an Ellsberg One Design amateur-built experimental airplane, N555TE, impacted the ground during performance of aerobatic maneuvers at the City-County Airport near Madras, Oregon. The commercial pilot, the sole occupant, sustained fatal injuries, and the airplane was destroyed by impact and fire damage. The airplane was registered to and operated by the pilot. Visual meteorological conditions prevailed and no flight plan was filed for the local personal flight that was conducted under 14 CFR Part 91. The airplane departed from the Madras Airport at an unknown time. According to a report by an officer with the Jefferson County Sheriff's Office who responded to the scene of the accident, the pilot was a "featured stunt pilot in the yearly Madras air show" and was practicing aerobatic maneuvers when the accident occurred. According to a written statement provided by a witness, who was standing outside a hangar on the airport observing the flight, the pilot made his third pass "to the North paralleling runway 34 on the east side of the asphalt and transitioned into a vertical climb, [and] at the top of the climb at an altitude of approximately 1500 [feet] AGL he put the aircraft into a controlled flat spin to the left." The witness reported that the pilot completed 4 to 5 rotations before recovering from the spin "on a heading towards the south at an altitude of about 70 feet AGL." The witness further reported that "at this point it appeared that the pitch was lowered to approximately -15 degrees at around 40 feet AGL but for a very short amount of time and very little forward speed was gained. At around 20 feet AGL it appeared that the pitch was increasing, but not arresting the vertical descent. The aircraft impacted the ground and immediately erupted in flames." According to a written statement provided by another witness, who was standing next to the first witness, the pilot made a high speed low level pass over the runway at about 60 feet agl and then pulled up, climbing to about 1,500 feet agl. The pilot then put the airplane into a flat spin and completed 4 to 5 rotations. At about 200 feet agl, the pilot recovered from the spin. According to the witness, "after his dive recovery it looked like he didn't have enough speed and pulled up and stalled and pitched forward and down and impacted at about [a] 45 degree angle and exploded on impact." An FAA inspector conducted an on scene examination of the wreckage and did not report finding evidence of any pre-impact mechanical discrepancies. The inspector reported that there was a ground scar approximately 10 feet long leading to the wreckage and that the airplane was consumed by fire with the exception of the steel frame fuselage and the engine. FAA records indicated that the pilot was the builder of the single-seat experimental airplane, which was issued its airworthiness certificate and operating limitations on September 11, 1996. According to a friend of the pilot, he had flown the airplane about 900 to 1,000 hours. The airplane's maintenance logbooks were not located during the investigation. The pilot held a commercial pilot certificate and a flight instructor certificate with single engine land and instrument ratings on both certificates. His most recent second class medical certificate was issued on February 19, 2005. On the application for this medical certificate, the pilot reported a total flight time of 4,000 hours and a flight time in the last six months of 150 hours. The pilot's flight logbooks were not located during the investigation. An autopsy of the pilot was performed by the Medical Examiner Division of the Oregon State Police in Clackamas, Oregon. Toxicology tests were performed by the FAA's Toxicology and Accident Research Laboratory. The tests were negative for drugs. Ethanol was detected in muscle. The toxicology report stated that "the ethanol found in this case is from sources other than ingestion." ## Aircraft - Registration: [N555TE](https://openairdocs.org/deregistered/N555TE-2007-11-27), registration cancelled 2007-11-27, S/N 94-0239, built 1996 (OpenAirDocs) - Reported make and model: Ellsberg One Design - Registry model: [Ellsberg Tom ONE DESIGN](https://openairdocs.org/model/ellsberg-tom-one-design) (registry code 05602MZ) (OpenAirDocs) - Registry engine: [Amateur-built UNKNOWN ENG](https://openairdocs.org/engine/amateur-built-unknown-eng) (registry code 99999) (OpenAirDocs) - Category: Airplane, amateur-built - Serial number: 0239 - Engines: Lycoming IO-360-C1EG 200 horsepower reciprocating - Damage: Destroyed - Fire: On-Ground - Flight: Personal, Part 91 - Airworthiness certificate: Special, Experimental (Special) - Departed: S33, Madras, OR - Airport: S33, City-County ## Flight crew As NTSB recorded them. NTSB leaves out names. - Pilot; age 69; injuries: fatal; flight instructor, commercial; airplane ratings: single-engine land; instrument ratings: airplane; medical: class 2, with waivers/limitations; seat: single; toxicology performed; flight hours: 4,000 total, 900 in this make and model ## Weather - Conditions: Visual (VMC), Day - Wind: 330° at 10 knots - Visibility: 10 statute miles - Temperature: 73 °F, dew point 39 °F - Altimeter: 29.87 inHg - Observed at: RDM, 25 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 20050625013189A](https://openairdocs.org/incident/20050625013189A), Jun 25, 2005: Amtr ONEDESIGN, Madras, OR, Destroyed, 1 fatal. (-23) The aircraft impacted the ground during performance of aerobatic maneuvers at the city-county airport near Madras, Oregon. The pilot sustained fatal… 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.