Pilot Debrief

CESSNA 421C near Floriston, CA — 2013-05-16

Final reportWPR13FA234
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Date
2013-05-16
Location
Floriston, CA, USA
Airport
RNO
Aircraft
CESSNA 421C
Registration
N421W
Category
Airplane
Highest injury
Fatal
Fatalities
1
Phase of flight
Descent

Probable cause

The pilot's failure to maintain airplane control during descent while operating in instrument meteorological conditions.

NTSB narrative

During a cross-country instrument flight rules (IFR) flight, the air traffic controller cleared the pilot to begin his initial descent for landing and issued a heading change to begin the approach. The pilot acknowledged the altitude and heading change. One minute later, the controller noticed that the airplane's radar track was not tracking the assigned heading. The controller queried the pilot as to his intentions, and the pilot replied that he was in a spin. There were no further communications with the pilot. The wreckage was subsequently located in steep mountainous terrain. A study of the weather indicated widespread cloud cover in the area around the time of the accident. A witness near the accident site reported that he heard an airplane in a dive but could not see it due to the very dark clouds in the area. He heard the engine noise increase and decrease multiple times. It is likely that the pilot entered into the clouds and failed to maintain airplane control. The changes in the engine noise were most likely the result of the pilot's attempt to recover from the spin. About 8 months before the accident, the pilot completed the initial pilot training course in the accident airplane and was signed off for IFR currency; however, recent or current IFR experience could not be determined. Examination of the fragmented airplane and engines revealed no abnormalities that would have precluded normal operation.

Analysis

Primary failure mode
Spatial disorientation
First missed decision gate
Pilot could have avoided entering clouds and maintained visual flight.

NTSB coding

Evidence available

  • ATC audio
  • ADS-B / radar
  • Photos
  • 18 docket documents
View NTSB final reportView NTSB docket

Docket documents18

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