Pilot Debrief

MOONEY M20M near Midlothian, VA — 2008-04-27

Final reportMIA08FA094
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Date
2008-04-27
Location
Midlothian, VA, USA
Aircraft
MOONEY M20M
Registration
N429RM
Category
Airplane
Highest injury
Fatal
Fatalities
2
Phase of flight
Initial climb

Probable cause

The pilot’s improper control inputs resulting from spatial disorientation.

NTSB narrative

The instrument-rated private pilot departed with an instrument flight rules clearance and encountered instrument meteorological conditions shortly after takeoff. He did not establish contact with air traffic control at any time during the flight, nor did he enter controlled airspace on the assigned heading of 180 degrees. According to the NTSB Air Traffic Control (ATC) Radar Study, the flight climbed to approximately 1,800 feet msl, and continued in a direction northwest of the departure airport while turning left, right, and then left with slight changes in altitude. The airplane then began a right descending turn with the bank angle and turn rate increasing beyond the standard rates and angles, and the load factor reached close to maximum limits. At some point near the end of the flight, during the right descending turn, the lower fuselage panel separated and the left rear window separated. The airplane impacted the ground then a house and both were destroyed by impact and postcrash fire. The pilot's wife reported a previous concern with a stuck flap. Although the impact and fire destroyed sections of the flight control push/pull tubes and components of the flap system, changes in direction to the left and right were consistent with the pilot controlling the airplane. Examination of the wreckage, including the flight control, flap, and speedbrake systems, did not reveal any preimpact mechanical malfunctions. Additionally, Mooney Flight Test personnel reported that the airplane is controllable with one flap fully extended and the other flap fully retracted. No evidence of preimpact failure or malfunction was noted to the engine or engine accessories. Risk factors for spatial disorientation were present at the time of the accident, including instrument meteorological conditions and maneuvering flight. The airplane’s sequence of turns during the departure and its subsequent spiral dive were conducive to vestibular illusions. Analysis of the radar data in the airplane performance study showed evidence of a flight path and associated increased g-loading that were consistent with the effects of spatial disorientation.

Analysis

Primary failure mode
Loss of control
First missed decision gate
Pilot could have aborted takeoff due to IMC conditions.

NTSB coding

Evidence available

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

Docket documents37

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