NTSB Factual Report

HISTORY OF THE FLIGHT

On December 20, 2010, about 1000 Pacific standard time, an Aero Commander 680FL, N316KW, collided with mountainous terrain, 6.5 miles north of Perris, California. The airplane was operated by the owner under the provisions of Title 14 Code of Federal Regulations, Part 91. The airline transport pilot was killed, and the airplane was substantially damaged. Instrument meteorological conditions prevailed, and no flight plan had been filed. The flight originated at Palm Springs International Airport, Palm Springs, California, about 0940. The airplane is based out of the Chino Airport, Chino, California.

On Saturday, December 19, 2010, the pilot and some family members flew the airplane from Texas with the intention of arriving at the Chino Airport that evening. The pilot resided in Riverside, California, and the airplane was based at the Chino Airport. Saturday night the pilot landed at 1919, and parked the airplane in Palm Springs, because the weather was not good enough to continue on to the Chino Airport. The pilot then rented a car and drove to his home in Riverside. The following morning the pilot rose early and drove back to Palm Springs with the intention of flying the airplane to the Chino Airport. Once at the Palm Springs Airport, he had the airplane fueled with 45 gallons of avgas, and left instructions to hold the rental car because he may return to Palm Springs if the weather had not improved. Federal Aviation Administration (FAA) records indicate that the pilot did not receive a weather briefing from a Flight Service Station, nor did he file a flight plan.

A Garmin GPSMAP 496 portable global positioning system (GPS) receiver was recovered from the airplane wreckage and the data was downloaded by the Safety Board’s Vehicle Recorders Laboratory. The GPS data log for December 20, 2010, shows that at 0928 the airplane departed from Palm Springs and headed west along the I-10 corridor towards the Banning Pass (elevation 2,600 feet msl) and into the Moreno Valley (elevation 1,500 feet). The airplane climbed to 2,500 feet mean sea level (msl) and for the majority of the flight the airplane maintained altitudes between 2,500 feet and 3,400 feet msl. At 0957, 6.5 miles west of Beaumont, California, at 2,700 feet, the airplane’s GPS track turned southwest away from a concentrated area of precipitation and directly towards Mount Russell (2,697 feet msl). Mount Russell rises about 1,000 feet above the floor of the Moreno Valley. At 0953, the pilot contacted March Air Reserve Base (ARB) arrival controller, reported his position as 4 miles west of the Banning Airport, and requested advisories through the Class C airspace to Chino. At 0956, the pilot reported that he was 7 miles east of March ARB. At 0958, the GPS track shows that the airplane comes within 50 feet of rising terrain. At 0959, the pilot stated that he was having difficulty maintaining VFR (visual flight rules) and asked for an IFR (instrument flight rules) clearance. No further communications with the pilot was recorded. The final GPS position was recorded at 1000, 2,600 feet msl, 0.4 miles east of the crash site. The terrain elevation in the vicinity of the crash site is 2,500 feet.

The GPS Specialist Factual Report is available in the official docket of this investigation.

PERSONNEL INFORMATION

The pilot, age 65, held an Airline Transport Pilot certificate for airplane multiengine land, a commercial pilot certificate for airplane single engine land and sea, with type ratings in the Boeing 737, 757, 767, 777, DC-9, DC-10, and L-188 airplanes. Additionally, he held a flight instructor certificate with ratings for airplane single engine, multiengine, and instrument, and an Airframe and Powerplant Mechanic certificate. A second-class airman medical certificate was issued to him on August 31, 2010, with the limitation that he wears corrective lenses. On the pilot’s most recent medical application he reported having 33,000 hours of flight time. Examination of a copy of the pilot’s logbook showed that he had flown 11 hours in the last 30 days, 3 hours of that in the accident airplane. He completed a flight review and instrument proficiency check on November 28, 2010.

AIRPLANE INFORMATION

The high wing, retractable landing gear, twin engine airplane, serial number 1753146, was manufactured in 1968. It was powered by two Lycoming IGSO-540-B1C, 380-hp engines, and equipped with two Hartzell HC-3BZ30-2A constant speed propellers. A review of copies of the airplanes maintenance logbooks showed an annual inspection was performed on April 2, 2010, at an aircraft total time of 2,240 hours. Operating hours since major overhaul (SMOH) on the left engine was 275.5, and 275.5 hours on the right engine. The most recent maintenance performed on the airplane were the oil changes performed on both engines on December 16, 2010, at total aircraft time of 2,260.8 hours. The Hobbs meter read 247.2 at the accident scene, which corresponds to a total aircraft time of 2,278.2 hours.

METEOROLOGICAL INFORMATION

The meteorological observation for Palm Springs at 0953, was calm winds; 10 miles visibility; scattered clouds at 2,500 feet above ground level (agl); a broken layer at 5,000 feet agl; and an overcast layer at 6,000 feet agl.

There were no meteorological observations for Chino Airport on the day of the accident.

Corona Municipal Airport, located 5 miles south of Chino, recorded weather observation at 0856, was 10 mile visibility; broken clouds at 6,000 feet agl; and overcast at 7,000 feet agl. At 0956; the conditions had deteriorated to 5 miles visibility; rain and mist; few clouds at 100 feet agl; and overcast at 3,700 feet agl.

March Reserve Air Base, elevation 1,536 feet msl, located 4 miles west of the accident site, 22 miles southwest of the destination airport, and is along the pilot’s route of flight reported at 0916, 10 miles visibility; few clouds at 800 feet agl; broken cloud layer at 2,200 feet agl; and overcast at 7,000 feet agl. Additionally, it noted a variable ceiling between 1,900 feet and 2,500 feet agl. At 0955, about the time of the accident, March ARB reported winds from 140 degrees at 11 knots; 10 miles visibility; light drizzle; few clouds at 900 feet agl; overcast at 1,500 feet agl; ceiling variable between 1,200 and 1,800 feet agl.

NEXRAD weather radar images from 0951 to 0959 on December 20, 2010, shows concentrated precipitation at the 3,027-foot msl level in the area surrounding the accident site.

The Aeronautical Information Manual (AIM) defines Marginal VFR (MVFR) as “Ceiling between 1,000 feet and 3,000 feet and/or visibility between 3 and 5 miles inclusive.”

WRECKAGE AND IMPACT INFORMATION

The wreckage was located by Rangers from the California Department of Parks and Recreation on December 20, 2010, in the late afternoon. The wreckage was distributed on the crest of a 2,500-foot peak. The terrain consisted of a moderate slope to the west featuring large rock outcroppings and boulders, populated by sparse brush vegetation. The initial point of impact was located on the northeast side of the peak, and the wreckage was distributed along a bearing of 250 degrees (magnetic) for 500 feet. The initial point of impact was identified by the debris of the left wing tip and red glass position light lens fragments. The empennage and tail section had been separated from the main cabin, and the entire wing span, minus the outboard section of left wing, had also separated from the fuselage. The left wing outboard section was located 140 feet to the north of the initial point of impact. The cockpit area was located about 20 yards downhill from the wing, and was observed in an inverted orientation, and exposed to the environment.

On January 28, 2011, a wreckage examination was conducted by the Safety Board investigator-in-charge (IIC), assisted by representatives from Textron Lycoming, Twin Commander Aircraft LLC, and the FAA. Examination of the airframe, engines, and propellers did not reveal any anomalies that would have prevented the normal operation of the airplane controls, engines, propellers, or cockpit instrumentation.

MEDICAL AND PATHOLOGICAL INFORMATION

An autopsy was performed on the pilot on December 21, 2010, by the Riverside County Sheriff-Coroner, Riverside. The autopsy lists the cause of death as “multiple blunt force traumatic injuries.”

Forensic toxicology was performed on specimens from the pilot by the FAA Forensic Toxicology Research Team CAMI, Oklahoma City, Oklahoma. The toxicology report stated no carbon monoxide was detected in blood, no cyanide was detected in blood, no ethanol was detected in urine, and ibuprofen was detected in urine.

ADDITIONAL INFORMATION

Advisory Circular AC61-134 addresses controlled flight into terrain awareness. The following section from AC61-134 applies to circumstances surrounding this accident.

“VFR-ONLY PILOTS OPERATING IN MARGINAL VFR/IMC CONDITIONS.

Operating in marginal VFR/IMC conditions is more commonly known as scud running. According to National Transportation Safety Board (NTSB) and FAA data, one of the leading causes of GA accidents is continued VFR flight into IMC. As defined in 14 CFR Part 91, ceiling, cloud, or visibility conditions less than that specified for VFR or Special VFR is IMC and IFR applies. However, some pilots, including some with instrument ratings, continue to fly VFR in conditions less than that specified for VFR. The result is often a CFIT accident when the pilot tries to continue flying or maneuvering beneath a lowering ceiling and hits an obstacle or terrain or impacts water. The accident may or may not be a result of a loss of control before the aircraft impacts the obstacle or surface. The importance of complete weather information, understanding the significance of the weather information, and being able to correlate the pilot's skills and training, aircraft capabilities, and operating environment with an accurate forecast cannot be emphasized enough.”

NTSB Probable Cause

The pilot’s decision to continue visual flight into instrument meteorological conditions, which resulted in an in-flight collision with mountainous terrain.