Pilot Debrief

CESSNA 140 near Poplar Grove, IL — 2016-04-30

Final reportGAA16CA212
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Date
2016-04-30
Location
Poplar Grove, IL, USA
Airport
C77
Aircraft
CESSNA 140
Registration
N4242H
Category
Airplane
Highest injury
None
Fatalities
0
Phase of flight
Descent

Probable cause

The pilot's visual disorientation and failure to monitor the altimeter during a night approach, which resulted in controlled flight into terrain.

NTSB narrative

The pilot reported that during a night visual meteorological condition flight he was about 5 nautical miles away from the destination airport and could see the runway lights. The pilot further reported that he was not able to see the terrain and it was a "black hole approach." As the pilot initiated a descent toward the runway, the airplane impacted terrain in a wooded area about 4 nautical miles west of the runway threshold. The pilot reported that he did not observe the terrain any time before the impact, but could see the bright runway lights. The left and right wings were substantially damaged. The pilot did not report any mechanical malfunctions or failures with the airplane that would have precluded normal operation. The Federal Aviation Administration Pilot's Handbook of Aeronautical Knowledge states in part: "A black-hole approach occurs when the landing is made from over water or non-lighted terrain where the runway lights are the only source of light. Without peripheral visual cues to help, pilots will have trouble orientating themselves relative to Earth. The runway can seem out of position (downsloping or upsloping) and in the worse case, results in landing short of the runway. If an electronic glide slope or visual approach slope indicator (VASI) is available, it should be used. If navigation aids (NAVAIDs) are unavailable, careful attention should be given to using the flight instruments to assist in maintaining orientation and a normal approach. If at any time the pilot is unsure of his or her position or attitude, a go-around should be executed."

Analysis

Primary failure mode
Spatial disorientation
First missed decision gate
Pilot could have executed a go-around when unsure of position.

NTSB coding

Evidence available

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

Docket documents5

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