Pilot Debrief

NANCHANG CHINA CJ-6A near Ocean City, MD — 2013-06-30

Final reportERA13FA309
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Date
2013-06-30
Location
Ocean City, MD, USA
Airport
OXB
Aircraft
NANCHANG CHINA CJ-6A
Registration
N116RL
Category
Airplane
Highest injury
Fatal
Fatalities
2
Phase of flight
Maneuvering

Probable cause

The pilot's failure to terminate the intentional aerobatic spin at an altitude adequate to prevent impacting the water. Contributing to the accident was the pilot's loss of situational awareness due to target fixation during the prolonged aerobatic maneuver.

Contributing factors

Contributing to the accident was the pilot's loss of situational awareness due to target fixation during the prolonged aerobatic maneuver.

NTSB narrative

Witness accounts and on-board video recordings of the accident flight revealed that the pilot initiated and performed a series of aerobatic maneuvers with the airplane before initiating a stall, rolling the airplane inverted, and entering a steady-state spin to water contact. The airplane completed 22 revolutions in the spin, with the engine running smoothly, and the stick held fully aft. Examination of the wreckage revealed no evidence of any preimpact mechanical anomaly. Review of the pilot's flight records revealed no evidence of formal aerobatic training. However, the records indicated that he had conducted aerobatic maneuvers, including, on at least one occasion, a flat spin. The on-board video recordings showed no signs of pilot distress or incapacitation and indicated that the pilot was actively engaged in controlling the airplane and was providing control inputs to maintain the spin to impact. There was no indication of any distracting event or of the pilot attempting to diagnose, troubleshoot, or respond to a perceived in-flight control, system, or engine anomaly. There were multiple cues available to the pilot that the maneuver should be terminated, including an increasing ground presence/perspective from the out-the-window view and the rapidly decreasing altitude indicated on the altimeter in the panel. However, the pilot failed to terminate the maneuver at an altitude adequate to prevent impacting the water. Therefore, it is most likely that the pilot lost situational awareness during the aerobatic maneuver/prolonged spin and did not recover from the spin before impact. Given the fact that this was a sustained aerobatic maneuver, it is possible that the pilot lost situational awareness due to target fixation, a phenomenon that can occur at varying levels ranging from a breakdown in an instrument scan to failing to pull out of an aerial application run. In these cases, the pilot has cues that a response is required and has the knowledge and skills necessary to successfully perform the response. However, because of the narrowing of attention resulting from the goal-directed activity associated with this phenomenon, a loss of overall situational awareness occurs and the appropriate response is not commanded/input. The circumstances of this accident are consistent with the loss of situational awareness due to target fixation. The pilot appears to have focused on the performance/sustainment of the spin maneuver and therefore misjudged or lost awareness of his exit altitude.

Analysis

Primary failure mode
Loss of control
First missed decision gate
Pilot could have refrained from performing aerobatic maneuvers over water.

NTSB coding

Evidence available

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  • 17 docket documents
View NTSB final reportView NTSB docket

Docket documents17

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