NTSB Factual Report

HISTORY OF FLIGHT

On July 4, 2002, at 1428 Alaska daylight time, a tundra tire-equipped experimental/homebuilt, Zawada Super Cuby airplane, N43Z, sustained substantial damage following an in-flight loss of control and subsequent impact with mountainous terrain, about 35 miles west of Cantwell, Alaska. The airplane was being operated as a visual flight rules (VFR) cross-country personal flight when the accident occurred. The private certificated pilot, and the sole passenger, received fatal injuries. Visual meteorological conditions prevailed at the airplane's point of departure, and no flight plan was filed. The flight originated at a private airstrip, located about 8 miles southwest of Wasilla, Alaska, at an estimated time of 1200.

A family member reported to search personnel that prior to leaving the family household, the accident pilot left a note stating his intentions to fly over various glaciers in an area of mountainous terrain within the Denali National Park, Alaska, and then return before dinner time. The family member added that the purpose of the flight was to show the passenger some Alaskan scenery. When the airplane did not return, the flight was reported overdue on July 6, 2002, at 0935.

On July 8, 2002, about 1300, airborne search personnel located the wreckage at the 5,000 foot msl level, approximately 1 mile west of the 5,800 foot summit of Anderson Pass. Anderson Pass is located about 90 miles north of the airplane's departure airstrip.

PERSONNEL INFORMATION

The pilot held a private pilot certificate with an airplane single-engine land rating. The most recent third-class medical certificate was issued to the pilot on May 31, 2002, and contained the limitation that the holder must wear corrective lenses.

According to the pilot's personal logbook that was located at the accident site, his total aeronautical experience consisted of about 1,418.6 hours. The last entry in the logbook was dated August 17, 2000, at which time the pilot underwent a biennial flight review (BFR).

No current or updated personal flight records were located for the pilot. On the pilot's application for medical certificate, dated May 31, 2002, the pilot indicated that his total aeronautical experience consisted of about 2,050 hours, of which none were accrued in the previous 6 months.

AIRCRAFT INFORMATION

No airframe or engine records were located for the accident airplane. A friend of the pilot stated that the pilot purchased the Wag-Aero, Super Cuby kit airplane in a partially assembled condition. It was completed by the pilot in Alaska, and registered by the pilot with the Federal Aviation Administration on October 1, 1994.

According to the pilot's friend, at the time of the accident, the airplane and engine had accumulated a total time in service of 725.5 hours, which matched the airplane's recording hour/tachometer reading.

METEOROLOGICAL INFORMATION

The closest official weather observation station is located at the Chulitna River Lodge, Chulitna, Alaska, which is located about 30 nautical miles southeast of the accident site. On July 4, 2002, at 1440, an automated weather observation system was reporting, in part: Wind, 350 degrees (true) at 6 knots; visibility, 40 statute miles; clouds, 3,500 feet scattered, 6,000 feet overcast; temperature, 54 degrees F; dew point, 39 degrees F; altimeter, 29.78 inHg.

At 1335, an automated weather observation system at Cantwell, Alaska, located about 35 nautical miles east of the accident site, was reporting in part: Wind, 080 degrees (true) at 5 knots; visibility, 20 statute miles; clouds, 5,000 feet broken, 8,000 feet broken, 20,000 feet overcast; temperature, 54 degrees F; dew point, 46 degrees F; altimeter, 29.79 inHg.

The FAA had no record of the pilot having requested or received a preflight or en route weather briefing.

COMMUNICATIONS

No communications were received from the pilot.

WRECKAGE AND IMPACT INFORMATION

The National Transportation Safety Board (NTSB) investigator-in-charge (IIC) examined the airplane wreckage at the accident site on July 8, 2002. The terrain surrounding the accident site consisted of a large mountain valley oriented about east/west. The east end of the valley, where the wreckage was found, has rising terrain of about 15 degrees sloping up toward a "U" shaped canyon, which leads to the summit of Anderson Pass. The wreckage came to rest near the center of the valley, in an upsloping rock and snow-covered area, adjacent to a small mountain ravine.

All of the airplane's major components were located at the main wreckage area. The airplane's fuselage and cabin came to rest on its left side, with the nose of the airplane oriented on a 275 degree heading. (All headings/bearings noted in this report are oriented toward magnetic north.)

The first observed point of ground contact was a circular-shaped disruption in the snow located about 4 feet forward of the airplane's nose. The disruption in the snow measured about 12 inches deep, and about 5 feet wide.

A single 3-inch deep, by about 12-foot long depression, was visible in the snow, emanating from the center of the circular-shaped disruption in the snow. The 12-foot long disruption in the snow matched the length and shape of the right wing leading edge. Embedded in the snow, along the length of the 12-foot long depression, were small pieces of black paint chips. The airplane's wing leading edges were painted black.

The wings remained attached to the fuselage, but were extensively distorted at the wing to fuselage attach point. Both wing lift struts remained attached to the wings and lower fuselage attach points.

The outboard half of the left wing had spanwise leading edge aft crushing with more crushing evident along the outboard portion of the leading edge. The left wing was pushed aft, and found lying along the left side of the fuselage.

The flight control surfaces remained connected to their respective attach points. Due to the impact damage, the flight controls could not be moved by their respective control mechanisms, but the continuity of the flight control cables was established to the cabin/cockpit area.

The instrument panel was crushed and twisted against the back of the engine firewall. The engine firewall was crushed against the back of the engine accessory case.

The propeller assembly remained connected to the engine crankshaft. One propeller blade exhibited almost 90 degree aft bending about mid-span, and the second propeller blade exhibited about 10 degrees aft bending about mid-span. Both propeller blades had minor leading edge gouging and chordwise scratching.

The engine sustained impact damage to the underside portion of the engine. The muffler was crushed upward against the engine, as was the muffler exhaust tube. The crushed, and folded edges of the muffler exhaust tube did not exhibit any cracking or breaks.

MEDICAL AND PATHOLOGICAL INFORMATION

A postmortem examination of the pilot was conducted under the authority of the Alaska State Medical Examiner, 4500 South Boniface Parkway, Anchorage, Alaska, on July 9, 2002. The cause of death for the pilot was attributed to multiple impact injuries. The medical examiner who conducted the postmortem examination noted in part, in his preliminary autopsy report: "While undressing the subject, a pharmaceutical container labeled Ultram 50 mg is found. There are seven (7) oval-shaped white tablets labeled "06/59" within this container."

The Federal Aviation Administration (FAA) Civil Aeromedical Institute (CAMI) conducted a toxicological examination on September 19, 2002. The examination revealed the presence of the following agents in the pilot's blood:

Tramadol (1.61 ug/ml, ug/g)

Hydrocodone (0.28 ug/ml, ug/g)

Dihydrocodeine (amount unspecified)

Paroxetine (0.142 ug/ml,ug/g)

Acetaminophen (2.605 ug/ml, ug/g)

The following agents were found in the liver tissue:

Tramadol (amount unspecified)

Paroxetine (amount unspecified)

The following agents were found in the bile:

Hydrocodone (0.26 ug/ml, ug/g)

Hydromorphone (0.958 ug/ml, ug/g)

Dihydrocodeine (0.035 mg/dL, mg/hg)

Codeine (amount unspecified)

Morphine (0.816 ug/ml, ug/g)

Tramadol (trade name Ultram), hydromorphone, and dihydrocodeine, are all prescription painkillers. Hydrocodone is a prescription narcotic painkiller that can also be produced by the metabolism of dihydrocodeine.

The toxicological examination revealed unspecified levels of codeine, in conjunction with 0.816 ug/ml of morphine, in the pilot's bile. Morphine is an active metabolite of codeine. No codeine or morphine was detected in the pilot's blood. Codeine is a narcotic painkiller, used for control of moderate to severe pain. Codeine is found in various prescription painkillers, as well as in some over-the-counter cough suppressants.

Additionally, the toxicological examination revealed that 0.142 ug/ml of paroxetine was detected in the pilot's blood, and unspecified levels of paroxetine were detected in liver tissue. Paroxetine (trade name Paxil) is a prescription antidepressant medication which is also prescribed to patients suffering from social anxiety disorders and panic attacks.

Acetaminophen is commonly used to treat headaches. It can be purchased over-the-counter under several different commercial brand-names, such as "Tylenol."

The NTSB medical officer reviewed the medical and pharmaceutical records obtained under subpoena from the accident pilot's internist, primary care physician, and rehabilitation medicine physician. According to the medical records obtained, the accident pilot had been under treatment from a variety of health care providers, primarily for the treatment of chronic back and neck pain, and clinical depression. According to the records obtained by the two known pharmacies that the pilot was using, his purchase of prescription painkillers increased in frequency from April 1997 up to the time of the accident. The pharmacy records indicate that the pilot was purchasing prescriptions from at least two different pharmacies. A copy of the NTSB medical officer's factual report is included in the public docket for this accident.

SEARCH AND RESCUE

On July 6, at 0935, a family member reported that the accident airplane was overdue. Search personnel from the Fairbanks, Alaska, squadron of the Civil Air Patrol, along with various privately owned aircraft, conducted an extensive search along the pilot's anticipated route of flight. The airplane wreckage was located by a Civil Air Patrol search airplane on July 8, 2002, about 1300.

Responding search and rescue personnel reported that as searchers approached the accident site, within close proximity to the wreckage, a faint emergency locator transmitter (ELT) signal was received. The searchers added that the location of the ELT antenna, and the resting position of the fuselage on it's left side, limited the ELT reception.

TESTS AND RESEARCH

The National Transportation Safety Board investigator-in-charge (IIC) recovered a GARMIN, model GPS III, hand held GPS unit from the accident site.

The GPS unit was shipped to GARMIN International, Inc. A technician at GARMIN International was able to reconstruct the entire route of flight for the accident airplane.

The technician who preformed the data extraction from the GPS unit reported that earlier on the day of the accident, at 1307, the accident airplane traveled westbound, through Anderson Pass, the same area in which the airplane wreckage was ultimately discovered. His report indicated that the accident airplane continued westbound, and at 1337 it landed on a river sandbar in an area commonly known as Muddy Creek. At 1406, the accident airplane departed from the Muddy Creek area, and proceeded eastbound towards Anderson Pass. The technician said that the GPS track revealed that as the airplane continued eastbound, it entered a mountain pass that is located about 1 mile east-northeast of Anderson Pass. The track data depicts an entry into that pass, followed by a sharp 190 degree left turn, and an exit from the pass to the southwest. The accident airplane's GPS track then proceeded south, turned to the east, and then headed eastbound into Anderson Pass. The last GPS track was recorded at 1428, with an indicated magnetic heading of 039 degrees.

WRECKAGE RELEASE

The National Transportation Safety Board released the wreckage to the owner's family, via a family friend, on July 15. The retained hand held GPS unit, along with the accident pilot's personal log book, were released to the family on October 10, 2002.

NTSB Probable Cause

The pilot's failure to maintain adequate airspeed which resulted in an inadvertent stall, and subsequent collision with terrain. A contributing factor was the pilot's impairment from the effects of prescription painkilling drugs.