Pilot Debrief

Cessna 182 near Imnaha, OR — 2020-06-24

Final reportWPR20LA194
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Date
2020-06-24
Location
Imnaha, OR, USA
Airport
25U
Aircraft
Cessna 182
Registration
N9169G
Category
Airplane
Highest injury
Serious
Fatalities
0
Phase of flight
Takeoff roll

Probable cause

The pilot’s excessively high pitch attitude and failure to maintain adequate airspeed during takeoff, which resulted in an exceedance of the airplane’s critical angle of attack and impact with terrain. Contributing to the accident was the pilot’s fatigue and his incomplete actions to abort the takeoff.

NTSB narrative

The pilot and three passengers were making an intermediate stopover at a mountain airstrip to camp with his family. They overflew the destination airport, and the pilot did not observe any concerns, but after they landed at the airport, the airplane became lodged in soft dirt. After several hours, they freed the airplane and decided to return to the airport they had departed from that morning. The pilot stated he felt the airplane begin to lift off the ground early during takeoff, so he maintained a nose low attitude to build up airspeed before starting a climb. When the airplane reached midfield, the pilot suddenly felt the airplane slow down and assumed the landing gear had contacted the runway. He wanted to abort the takeoff, but instead decided to fly the airplane as it had suddenly started to climb. Nearing the end of the runway he shoved the yoke forward after he heard the stall warning horn, but the airplane rolled to the right and impacted the ground. The pilot reported no preimpact mechanical malfunctions or failures with the airplane or engine that could have precluded normal operation. Contrary to the pilot’s recollection of events, flight data showed the airplane pitch increased excessively during the takeoff and the initial climb, and engine power decreased to about idle power as the airplane rotated, continued to climb, and airspeed decreased below stall speed. The stall warning horn likely engaged about the time the airplane’s critical angle of attack was exceeded, resulting in an aerodynamic stall and subsequent impact with terrain. Performance computations for the accident flight were consistent with the pilot’s, which suggested the airplane had sufficient takeoff distance to depart the runway, despite a high-density altitude. Weight and balance computations showed that the airplane was not over gross weight or outside of center of gravity limitations but that it was in a state of forward center of gravity at the time of the accident. The forward center of gravity would have resulted in a nose-heavy condition that required additional back pressure to maintain control during takeoff. The investigation did not find any evidence to suggest the airplane “slowed” during takeoff as the pilot suggested, but a wet patch on the runway or natural obstacles such as small rocks could have been present and adversely affected the takeoff roll. The accident pilot was likely fatigued after working for several hours to free the airplane from being lodged in soft dirt. This factor, coupled with stress and the pilot’s reported self-induced pressure to depart the airport, may have impaired the pilot’s judgment and decision making, causing him to overlook some of the risks associated with this departure. The fatigue likely also affected his ability to properly respond during the takeoff attempt.

Analysis

Primary failure mode
Human factors
First missed decision gate
Pilot could have aborted takeoff when feeling the airplane slow down.

NTSB coding

Evidence available

  • FDR / data
  • Photos
  • 14 docket documents
View NTSB final reportView NTSB docket

Docket documents14

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