NTSB Factual Report

HISTORY OF FLIGHT

On November 21, 1993, at 1855 hours Pacific standard time, a Cessna 172M, N5312R, collided with terrain following an in-flight loss of control near Julian, California. The pilot was conducting a visual flight rules personal flight to Steller Airpark, Chandler, Arizona. The airplane, operated by the pilot/owner, was destroyed. The certificated private pilot and his certificated private pilot/passenger sustained fatal injuries. Instrument meteorological conditions prevailed. The flight originated at Montgomery Field, San Diego, California at 1828 hours as a night cross-country flight to Chandler, Arizona. The pilot did not file a flight plan, nor was he required to.

The pilot was receiving visual flight rules (VFR) advisories and flight following from the Federal Aviation Administration (FAA) San Diego Terminal Approach Control (TRACON). According to recorded radar data obtained from San Diego TRACON, the aircraft had been assigned a discrete transponder code of 7264, and was climbing to an altitude of 9,500 feet mean sea level. The last aircraft position recorded by the radar system was at 1854:49 hours at a mode C reported altitude of 9,100 feet mean sea level. This position was noted to be about one mile from the accident site location.

The recorded radar data mode C reported altitude track history of the aircraft was reviewed. The last four recorded radar beacon returns showed altitudes of 9,400, 9,400, 9,500 and 9,100 feet respectively. The time intervals of the four recorded radar returns were spaced about one minute apart from 1851:44 to 1854:49.

At the time the aircraft disappeared from the San Diego TRACON radar, it also disappeared from the FAA Los Angeles Center radar. The radar disappearance was accompanied by a simultaneous loss of radio contact with the pilot. The last recorded transmission from the pilot was, "We're in a flat (blocked out), we're going to lose it dad."

The family became concerned when the aircraft was overdue, and contacted Riverside Flight Service Station personnel about 2230 hours. An ALNOT (alert notice for missing aircraft) was issued for the aircraft. San Diego County Sheriff's Department personnel and the San Diego Branch of the U. S. Customs searched the area for several hours on the night the ALNOT was issued without success. The air search was resumed the next morning by San Diego County Sheriff's Department personnel. The Sheriff's Department located the wreckage of the airplane at approximately 0735 hours.

The accident site is located about north 32.49 degrees latitude and west 116.24 degrees longitude. The accident occurred during the hours of darkness.

CREW INFORMATION

The pilot held a private pilot certificate which was issued on September 10, 1990, with airplane ratings for single-engine land aircraft. The most recent third class medical certificate was issued to the pilot on June 13, 1993, without limitations. According to the FAA Civil Aeromedical Institute Certification Division, the pilot reported a total of 270 hours of aeronautical experience as of his last reported FAA medical application form. According to pilot logbook entries, the pilot's total aeronautical experience consisted of about 308.5 hours of flight time. The pilot's records indicated a total of 49 hours of night flying time. The pilot's logbook did not record any flight time in the 90-day period preceding the accident.

The pilot had complied with the biennial flight review requirements of the current Federal Air Regulations by receiving his single-engine refresher on October 3, 1992.

Neither the pilot nor his pilot-rated passenger possessed an instrument rating.

AIRCRAFT INFORMATION

The airplane was registered to the pilot's father, the occupant reportedly flying in the right seat of the aircraft the night of the accident.

According to aircraft records which were reviewed during the conduction of the investigation, the last annual inspection was performed on August 29, 1993. The aircraft had accrued a total time of 3748.4 hours as of the above mentioned date. National Transportation Safety Board investigators were unable to determine the number of hours flown since the annual inspection, due to impact damage to the cockpit.

The aircraft originally had engine serial number L-382117-27A installed. The engine was removed and replaced with engine serial number L-24324-27A at an unknown date. The engine was overhauled in June of 1992 by Button Aviation Inc., Chandler, Arizona. The engine total time is unknown, but it had accumulated 198.5 hours since major overhaul at the time of its last annual inspection.

METEOROLOGICAL INFORMATION

The mother of the first pilot reported to Safety Board investigators that she personally witnessed her son obtain a weather briefing prior to the flight. She said her son called the 1-800-WX-BRIEF telephone number to obtain the weather briefing. She said several other members of the family were present during the briefing, and that her son remarked to the other family members that "they would be home early due to the 17-knot tailwind en route." Safety Board investigators contacted FAA Western Pacific Region Headquarters, Air Traffic (AWP-542), and asked that they search the flight service station records for a transcript of this briefing. San Diego, Hawthorne, and Riverside Flight Service Stations all reported negative contact for a weather briefing, although the 15 days that transcripts normally are saved had passed. (For additional information, see Record of Conversation, which is attached.)

The closest official weather observation facility is located about 33 nautical miles to the west of the accident site at Mirimar Naval Air Station, San Diego, California. A weather observation was taken by a weather observer at 1955 hours local time on November 21, 1993. The report from that observation was: "estimated 12,000 broken, visibility 7 miles, temperature 62 degrees (fahrenheit), dew point 54 degrees (fahrenheit)."

A weather observation was taken by a weather observer located at San Diego International Airport at 1950 hours local time on November 21, 1993. The observation noted in part: "measured 8,500 overcast, 10 miles visibility, temperature 63 degrees fahrenheit, dew point 59 degrees (fahrenheit), wind from 160 (degrees) at 04 knots, altimeter 30.01 inHg, few stratocumulus, moon dimly visible."

Safety Board investigators interviewed the participants in the search and rescue efforts to locate the downed aircraft. The San Diego Sheriff's Department Aerial Support Detail said in part, "...upon our arrival, the sky was partially obscured with cloud cover, with a partial moon that periodically broke through." Prior to their departure to search for the aircraft, the officer reported that "...we learned from LA Center (Los Angeles Air Route Traffic Control Center), that they had recently received a pilot report from the Julian area advising downdrafts and turbulence in the area...the pilot report advised of losing 200-300 feet of altitude and 20-30 knots of airspeed."

Additionally, statements were received from the U. S. Customs Service crews who responded in a Cessna Citation and BK-117 helicopter to assist in the search for the downed aircraft. The crew from the BK-117 helicopter stated they encountered "moderate" turbulence in the area.

An aviation safety inspector from the FAA San Diego Flight Standards District Office (FSDO) interviewed a refueler who fueled the accident airplane prior to departure. The refueler stated that he was told by a pilot who flew in from the "Julian area" about 1900 hours that "the cloud bases were about 7,000 feet." (See Record of Conversation, attached to this report.)

WRECKAGE AND IMPACT INFORMATION

The accident site is located about 4 miles east of Pine Valley, California. The site is located on a hill with about a 45-degree slope. The hill is vegetated with manzanita bushes and yucca plants ranging in height to about five feet.

The main wreckage was located on the slope of the hill about the 5,324 foot level, which is about 125 feet from the top of the hill. The main wreckage consisted of the airplane, both wings, the empennage, and the engine. The airplane was oriented on a magnetic bearing of 240 degrees with the associated debris path continuing downhill. There was no postcrash fire, although the area did exhibit some scarring and burned brush from a previous fire.

The main impact crater was located about 30 feet from the initial impact area. Portions of the number one and three engine cylinders were found in this area. The engine separated from the aircraft. The oil sump and accessory case were not recovered at the accident site.

Cylinders number 2 and 4 spark plugs remained with the cylinders. The top number 2 and the bottom number 2 and 4 plugs were broken. Visual examination of the electrodes revealed they were dry and, according to the Lycoming representative, showed normal wear. The number 1 cylinder assembly and the head section of the number 3 cylinder separated from the engine, and parts from those cylinders were found in the initial impact crater. The number 4 cylinder exhaust stack remained with the cylinder. The exhaust stack exhibited ductile crushing and twisting.

The carburetor separated from the engine and was located in the debris path. The housings were separated, and the upper housing was not located. A metal float assembly was present in the lower housing assembly. The air inlet filter assembly remained attached to the lower housing.

The oil sump assembly also separated from the engine. The oil pressure screen housing was found in the debris path. The pressure screen itself was not located.

The accessory case separated from the engine. Continuity of the valve and gear train components could not be performed due to impact damage.

No evidence of any preimpact mechanical failure to any rotating or reciprocating component of the engine was observed during the on-site examination.

One propeller blade was located in the main impact crater with the blade broken in half at the midspan of the blade. Leading edge damage was found on the propeller blade, as well as "S" twisting and chordwise scratches. An approximate 1/2-inch gash was noted on the leading edge of the propeller blade.

Green glass, consistent with right navigation lens assembly material, was located at the initial impact site. This ground scar was noted by freshly broken bushes and loose soil.

Portions of the empennage, fuselage, and front and rear seats were located about 110 feet from the initial impact location. Additionally, pieces of the alternator, carburetor, nose gear strut, and the remaining portions of the engine assembly were located about 90 feet from the initial impact location.

The baggage door and left fuselage section were located approximately 120 feet from the initial impact site.

Control continuity could not be established due to airframe damage. Additionally, flap settings could not be determined due to control surface damage.

MEDICAL AND PATHOLOGICAL INFORMATION

Autopsies were performed on the two occupants by Dr. Mary K. Clarke, M.D., from the San Diego County Coroner's office on November 23, 1993. The cause of death for both occupants was listed as "Blunt Force Injuries."

Specimens from both occupants were submitted to the FAA Civil Aeromedical Institute for toxicological examination. Negative results were reported for all screened drugs for both the pilot and his passenger.

ADDITIONAL INFORMATION

The aircraft wreckage was released to Mr. Michael Wilson, representing the owner, on November 30, 1993. Mr. Wilson was appointed as the Power of Attorney for the family.

NTSB Probable Cause

THE PILOT'S FAILURE TO MAINTAIN AIRCRAFT CONTROL. FACTORS IN THIS ACCIDENT WERE: 1) THE DARK NIGHT AND LACK OF AMBIENT LIGHT WHICH RESULTED IN THE PILOT INADVERTENTLY FLYING FROM VISUAL METEOROLOGICAL CONDITIONS INTO INSTRUMENT METEOROLOGICAL CONDITIONS; 2) THE PILOT'S LACK OF INSTRUMENT FLIGHT EXPERIENCE, AND 3) SPATIAL DISORIENTATION.