VFR into IMC · NTSB WPR14FA244

GRUMMAN AMERICAN AVN. CORP. AA 5B — Florence, OR

2 fatal IMCLow altitude
DateJune 15, 2014
LocationFlorence, OR
AircraftGRUMMAN AMERICAN AVN. CORP. AA 5B
Purpose of flightPersonal
ConditionsDay · Instrument Meteorological Cond
Phase / occurrenceManeuvering Loss of visual reference
Pilot age68
Pilot total time660 hrs · Building experience
Time in typeUnknown
Fatalities2

Probable cause

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

NTSB findings

  • Personnel issues-Psychological-Perception/orientation/illusion-Spatial disorientation-Pilot - C
  • Personnel issues-Task performance-Use of equip/info-Aircraft control-Pilot - C
  • Environmental issues-Conditions/weather/phenomena-Ceiling/visibility/precip-Low ceiling-Effect on operation - C
  • Environmental issues-Conditions/weather/phenomena-Ceiling/visibility/precip-Low visibility-Effect on operation - C
  • Aircraft-Aircraft oper/perf/capability-Performance/control parameters-(general)-Not attained/maintained - C

What happened

A witness reported observing the noninstrument-rated private pilot departing the airport in marginal visual meteorological conditions; the pilot was conducting a personal flight. The witness further reported that, about 1 hour later, he could hear airplane engine noise approaching the airport but that he could not see the airplane due to low ceilings and visibility. The witness also noted that the weather conditions were quickly deteriorating. Another witness reported that, while he was walking along the beach, he heard airplane engine noise in the low clouds, which he estimated were about 100 ft above ground level (agl). This witness reported that a small airplane then emerged from the clouds above the river traveling westbound away from the airport and that the airplane then "pitched up and reentered the cloud[s]." Shortly after, he saw the airplane exit the low clouds about 400 yards offshore in a near-vertical attitude with the right wing low before it impacted the ocean. No radar data depicting the accident flight were available. A majority of the airplane was not located in the ocean; therefore, postaccident airframe and engine examinations could not be conducted.

An automatic weather observation system located 2 1/2 miles from the accident site reported overcast clouds at 300 ft agl and visibility of 1 1/4 miles around the time of the accident. Witnesses estimated that the actual ceiling and visibility were lower near the accident site. In addition, a band of low stratiform-type clouds was present over the coast and the accident site. The low cloud ceiling and restricted visibility conditions would have been conducive to the development of spatial disorientation as the noninstrument-rated pilot maneuvered in the low-visibility conditions. The airplane's rapid descent from the clouds was consistent with the pilot's flight into instrument meteorological conditions and subsequent loss of airplane control due to spatial disorientation.

Postaccident toxicology testing detected 6-ß-natrexol, the primary metabolite of naltrexone, in the pilot's blood and liver. Naltrexone alone is not known to be generally impairing, but early in treatment, its use can precipitate symptoms of withdrawal. Without more information about the underlying condition that led to the pilot's use of naltrexone, it could not be determined whether or not the condition contributed to the accident.

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 →