VFR into IMC · NTSB CEN21LA200

AEROPRO CZ S R O A240 — Richmond, IN

1 fatal Low-time pilotIMC
DateApril 25, 2021
LocationRichmond, IN
AircraftAEROPRO CZ S R O A240
Purpose of flightPersonal
ConditionsDay · Instrument Meteorological Cond
Phase / occurrenceInitial climb Loss of control in flight
Pilot age78
Pilot total time100 hrs · Low time
Time in typeUnknown
Fatalities1

Probable cause

The noninstrument-rated pilot’s intentional flight into instrument meteorological conditions, which resulted in spatial disorientation and loss of airplane control.

NTSB findings

  • Personnel issues-Psychological-Perception/orientation/illusion-Spatial disorientation-Pilot
  • Personnel issues-Task performance-Use of equip/info-Aircraft control-Pilot
  • Personnel issues-Action/decision-Info processing/decision-Decision making/judgment-Pilot

What happened

The pilot obtained a weather briefing and filed a visual flight rules flight plan a few minutes before takeoff. An AIRMET advisory for instrument flight rules conditions was in effect, and the weather at the airport about the time of the accident included a cloud ceiling of 200 ft above ground level and 1/2-mile visibility in fog.

After takeoff, the airplane entered a climbing right turn and reached an altitude of approximately 2,045 ft with a right bank angle of about 40°. The airplane continued in a right turn and began to descend; its bank angle ultimately reached about 90°, and the average descent rate during the final portion of the flight was about 2,041 ft per minute.

The airplane impacted an open field about 1/2 mile south-southwest of the airport and was destroyed by a postimpact fire. Postaccident airframe and engine exams did not reveal any anomalies consistent with a preimpact failure or malfunction; however, the examinations were limited by the extent of the post-impact fire.

The pilot held a student pilot certificate, and he did not hold a medical certificate. Autopsy findings and health information revealed that the pilot had an enlarged heart, high blood pressure, severe coronary artery disease, and a history of five-vessel coronary artery bypass surgery. While the pilot’s cardiovascular disease placed him at an increased risk for a sudden cardiac event, given the circumstances of this crash, it is unlikely that sudden incapacitation from the pilot’s cardiovascular disease was a factor in this accident.

Postmortem toxicology testing detected gabapentin prescribed for chronic nerve pain and duloxetine prescribed for general anxiety. Both medications are impairing especially when first prescribed or with dosage adjustments. It is unknown how long the pilot was taking these medications and whether any side effects had been experienced; however, it is unlikely that effects from the pilot’s use of duloxetine and gabapentin were factors in the accident.

The low visibility conditions at the time of the accident and the pilot’s lack of training in instrument flight were conducive to the development of spatial disorientation, and the airplane’s flight track after takeoff was consistent with the known effects of spatial disorientation. It is likely that the pilot experienced spatial disorientation after takeoff into instrument meteorological conditions, which resulted in a loss of control.

An editorial "what led to it / how to avoid it" analysis for this accident is generated separately and will appear here.

View the official NTSB docket →