Pilot Debrief

CONSOLIDATED VULTEE BT-13A near Camas, WA — 2021-04-21

Final reportWPR21FA170
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Date
2021-04-21
Location
Camas, WA, USA
Airport
1W1
Aircraft
CONSOLIDATED VULTEE BT-13A
Registration
N53331
Category
Airplane
Highest injury
Fatal
Fatalities
1
Phase of flight
Landing

Probable cause

The pilot’s exceedance of the airplane’s critical angle of attack during an aborted landing, resulting in an aerodynamic stall and impact with terrain.

NTSB narrative

The flight instructor was providing recurrent training to the pilot in the tailwheel-equipped airplane. They had completed several takeoffs and landings at a nearby airport before returning to the departure airport. The first approach to the runway resulted in a go-around due to an unstable approach, and following the second approach, the pilot receiving instruction performed a three-point landing. During the landing roll, the airplane veered left and exited the runway, and the pilot applied full power and “immediately pitched up.” The airplane climbed in ground effect to about 30 ft, then entered a left turn, and its bank angle continued to increase before the airplane impacted terrain. The airplane came to rest adjacent to a hangar in a nose-low, near-vertical attitude. The pilot was fatally injured. The instructor added that, although he had been guarding the flight controls, due to the low altitude of the event, he did not have time to react before impact. Toxicology testing of the pilot receiving instruction detected diphenhydramine, a sedating antihistamine commonly available over the counter in a host of preparations intended to treat cold and allergy symptoms and to induce sleep. The range of levels where effects are expected are above 25 ng/ml, but the drug undergoes significant post-mortem redistribution and levels found in cavity blood likely do not accurately reflect antemortem levels. Although the pilot receiving instruction could have been impaired somewhat by the effects of a small amount of diphenhydramine in his system, some of those effects would have most likely been overcome by the adrenalin naturally produced in the emergency situation. It is therefore unlikely that the small amount of diphenhydramine contributed to the accident circumstances. The accident is consistent with the pilot’s exceedance of the airplane’s critical angle of attack during an aborted landing, which resulted in an aerodynamic stall and impact with terrain.

Analysis

Primary failure mode
Loss of control
First missed decision gate
Pilot could have aborted the landing earlier to avoid loss of control.

NTSB coding

Evidence available

  • Photos
  • 7 docket documents
View NTSB final reportView NTSB docket

Docket documents7

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