Pilot Debrief

PIPER PA 28-180 near Lake Worth, FL — 2015-10-13

Final reportERA16FA012
Sign in to save
Date
2015-10-13
Location
Lake Worth, FL, USA
Airport
LNA
Aircraft
PIPER PA 28-180
Registration
N57312
Category
Airplane
Highest injury
Fatal
Fatalities
1
Phase of flight
Approach

Probable cause

A loss of control for reasons that could not be determined based on the available information.

NTSB narrative

The private pilot was conducting a personal cross-country flight. The pilot utilized the destination airport's common traffic advisory frequency (CTAF) to report that he was 3 miles east of the airport and that he planned to enter a midfield left downwind leg for the runway. He then reported on that he was turning a left base leg for the runway. No further communications were received from the pilot. A radar plot showed the airplane flying past the runway centerline and then making an S-turn before radar contact was lost. Postaccident examination of the airframe and engine revealed no evidence of any mechanical failures or malfunctions that would have precluded normal operation. The pilot's autopsy revealed that he had significant heart disease with enlargement and wall thickening. He also had diffuse coronary artery disease with 75 percent stenosis of the left anterior descending and right coronary arteries and 25 percent stenosis of the left main and left circumflex coronary arteries. There was also mild calcification of the mitral valve leaflets. The pilot's coronary artery disease put him at a high risk for acute ischemia, which can cause chest pain, shortness of breath, or decreased blood pressure. He was also at increased risk for an arrhythmia, which can result in loss of consciousness. None of these events would leave visible evidence at autopsy. Given the circumstances of the accident and the pilot's cardiac conditions, it is possible that he became acutely impaired or incapacitated by symptoms from his cardiac disease and that this could have resulted in the loss of aircraft control. However, given the limited available information, it could not be determined whether the loss of control was the result of incapacitation or if there was another reason that the aircraft departed controlled flight and the pilot was unable to regain control.

Analysis

Primary failure mode
Human factors
First missed decision gate
Pilot failed to maintain proper approach path to runway.

NTSB coding

Evidence available

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

Docket documents12

Related mishaps