NTSB Factual Report

HISTORY OF FLIGHT

On January 13, 2015, about 2058 eastern standard time, a Cessna 152, N757ZM, collided with a public beach at New Smyrna Beach, Florida. The commercial pilot was fatally injured and the airplane was substantially damaged by impact forces. The airplane was registered to a private company and was operated by the pilot under the provisions of Title 14 Code of Federal Regulations (CFR) Part 91 as a personal flight. Night, instrument meteorological conditions (IMC) prevailed for the flight, and no flight plan was filed. The local flight originated from Massey Ranch Airpark (X50), Edgewater, Florida, about 2040.

Prior to the accident flight, the pilot, who was a Japanese citizen, contacted Flight Time Building LLC to purchase a block of flight time in a Cessna 152. According to the company's website, the company sold "blocks" of flight time to licensed pilots, with 50 hours being the minimum-sized block. The company normally dispatched an airplane to the pilot upon completion of a ground and flight "checkout." According to the owner of Flight Time Building, on the day prior to the accident, the pilot flew a local flight with an instructor, followed by a cross country flight with a safety pilot, who was an instructor-in-training. The owner reported that the pilot was not "signed off" for solo flight after the flights on January 12. The flight instructor stated that he needed to see "improved landings" before he could approve her for solo flight.

On the day of the accident, she flew an undetermined number of local, solo flights without the knowledge of Flight Time Building personnel. She possessed the keys to the accident airplane since she had flown it on the previous day with the safety pilot. She refueled the airplane at her own expense and initiated the accident flight, which was a local, night flight in the traffic pattern at X50.

At 2042:03, a radar target correlated to be the accident airplane was about 1 nautical mile (nm) south of X50. Radar data indicated the aircraft was in a left, 360-degree turn.

At 2047:22, the accident pilot pilot transmitted on the emergency frequency, 121.5 MHz, "hello," followed by two more transmissions of the her saying "hello." This coincided with radar data that depicted the accident aircraft emitting a transponder code of, or "squawking," 7700 (emergency) about 3.5 nm south of X50, or about 8.4 nm south of New Smyrna Beach airport (EVB).

At 2047:42, the pilot stated "uh I don't know where I am I want to land." At 2047:52, the Daytona Beach (DAB) Radar South controller transmitted, "The aircraft that doesn't know where they are at; are they at 1,700 feet squawking emergency and 1200?" At 2048:21, the pilot transmitted "I want to land."

The EVB local controller heard the pilot asking for assistance on 121.5 MHz. Because the aircraft was close to EVB, he was able to establish communications. Between 2048 and 2053, the EVB local controller provided assistance to the pilot. The pilot advised the EVB air traffic controller that she could see the ground but could not maintain visual flight conditions. When the EVB local controller turned the pilot toward EVB, the pilot reported that she could see the airport, but a short time later said she could no longer see it. The EVB local controller then attempted to transfer communications to DAB approach control on 125.35 MHz.

At 2053:52, the EVB local controller advised DAB ATC that the aircraft was proceeding towards DAB, and that EVB would have the lights set on high intensity if they needed the airport. The DAB Radar South controller replied, "thanks, we are going to try it." At 2054:35, the pilot of N757ZM transmitted "hello" on the emergency frequency 121.5, and at 2054:41 continued, "on 125.25 no ah contact." The pilot had been instructed by EVB to contact DAB on 125.35 MHz. The DAB Radar South controller responded on 121.5 by asking the pilot if she could hear DAB.

At 2054:49, the pilot again transmitted that she was unable to reach anybody on 125.25. The DAB air traffic controller replied "ok just stay on this frequency you are all right, maintain your present altitude." The EVB local controller informed the DAB air traffic controller that the pilot could not hear DAB on 125.35. DAB advised the EVB local controller that the pilot was on the wrong frequency, and that the DAB controller would assist the pilot on the emergency frequency.

At 2055:15, the pilot transmitted "hello." The DAB air traffic controller established communications with the pilot on 121.5 and asked the pilot if she could hear DAB; the pilot responded, "I can hear you."

At 2055:22, the DAB controller instructed the pilot to "remain calm and to maintain present altitude." The DAB controller told the pilot to continue the right turn northbound towards EVB, and that the airport would be off the right side. The DAB controller added that EVB would have all the runway lights turned on to high and instructed the pilot to advise when she saw the lights.

At 2055:40, the pilot transmitted on 121.5 that she was heading 100 degrees, and asked the DAB air traffic controller what heading she needed to fly. The DAB air traffic controller told the pilot that if she were able, to turn left heading 360 and that EVB would be at the pilot's 12 o'clock position and one and a half nautical miles. After an unintelligible transmission from the pilot, the DAB controller told the pilot she was not required to read back any further transmissions, and to make the turn. The DAB controller instructed the pilot to advise when she saw the lights at EVB. The pilot verified the heading and asked if she needed a left turn, heading 300. The DAB air traffic controller instructed the pilot to continue a left turn, heading 360 and reiterated the EVB position relative to the aircraft. The pilot acknowledged the turn.

At 2056:57, the DAB air traffic controller told the pilot to land any runway at EVB if she saw the runway lights. At 2057:06, the pilot stated she was at 600 feet and the DAB air traffic controller instructed the pilot to maintain her altitude until she saw the airport. The pilot replied that she was in the clouds. The DAB controller told the pilot, "okay don't worry, don't worry, don't worry, don't worry ma'am, just calm down, calm down; make a left turn." The DAB air traffic controller then instructed the pilot to make a left turn to climb because she had been in a descent. The DAB air traffic controller advised the pilot it was okay to be in the clouds but that she needed to climb.

At 2057:48, the DAB controller asked the pilot if she was climbing, and told her that she needed to maintain at least 1,000 feet. The pilot acknowledged the climb to 1,000 feet, followed by an unintelligible transmission. The DAB air traffic controller reiterated the climb to 1,000 feet and for the pilot to advise DAB when she was comfortable. There were no further transmissions from the pilot.

A short time later, radar and radio contact was lost and the airplane crashed onto New Smyrna Beach, in shallow water. Radar data indicated a descending, right turn prior to impact. The altitude of the last observed radar target was 500 feet above mean sea level. Emergency responders arrived at the accident site shortly thereafter in an attempt to provide assistance.

PERSONNEL INFORMATION

The pilot, age 38, held a commercial pilot certificate with ratings for airplane single engine land, airplane multi-engine land, and instrument airplane. She was issued a Federal Aviation Administration (FAA) third-class medical certificate on August 18, 2014, with a restriction to wear corrective lenses.

Pilot records recovered from the wreckage indicated that the pilot had logged about 416 total hours of flight experience as of January 7, 2015. She had logged about 1.3 hours of night time and about 6.1 hours of actual instrument time prior to the accident flight. Logbook entries showed that she completed a 14 CFR Part 61.55 flight review and a 14 CFR 61.57(d) instrument proficiency check (IPC), in a Cessna 152, at Torrance, California on November 19, 2014. The flight review and IPC were performed with different flight instructors. Her pilot logbook indicated she flew about 2.4 hours on June 30, 2014, in a Beech BE-58 and did not log another flight prior to her flight review and IPC of November 19, 2014.

FAA inspectors interviewed the flight instructors who performed the flight review and IPC. Both flight instructors reported that the accident pilot showed no weaknesses, handled the radios during the flight, was familiar with the local area, and was a "good pilot."

AIRCRAFT INFORMATION

The airplane was a Cessna model 152 that was manufactured in 1977. The high-wing, fixed tricycle landing gear airplane was powered by a Lycoming O-235-L2C engine, rated at 110 horsepower at 2,550 rpm and was equipped with a Sensenich 72CK56-0-54 metal, fixed-pitch propeller.

According to the maintenance logbooks provided by the owner, the most recent annual inspection of the airframe and engine was completed on October 27, 2014, at 502.1 hours tachometer time. The observed tachometer time at the time of the accident was 525.8 hours. The aircraft total time was not recorded in on the logbook entries, and the owner estimated that the total time of the airframe was about 12,000 hours.

METEOROLOGICAL INFORMATION

The National Weather Service (NWS) Surface Analysis Charts for 1900 and 2200 on January 13, 2015 depicted a cold front moving across central into southern Florida with cold air stratus clouds behind the front. Numerous station models behind the front depicted visibilities restricted in mist or fog, with temperature-dew point spreads of less than 5° F, and in the vicinity of the accident site less than 3° F.

The NWS Weather Depiction Chart for 2000 depicted an extensive area of IMC extending from the accident site and across most of all of central and northern Florida, Georgia, South Carolina, portions of southern and eastern North Carolina, and portions of Tennessee, Alabama, Mississippi, and Louisiana. A second area of IMC was also identified over southern Florida ahead of the front in the vicinity of West Palm Beach with marginal visual meteorological conditions extending through most of central and into southern Florida. The closest visual meteorological conditions with ceilings above 3,000 feet and visibility greater than 5 miles were over southwestern Florida, and extreme south Florida. The chart indicated that fog and low ceilings were not a localized event over the New Smyrna Beach area, but extended over most of the area.

The National Center for Atmospheric Research regional radar mosaic for 2100 depicted no significant weather echoes associated with rain showers or thunderstorms in the vicinity of the accident site during the period.

The NWS 12-hour Low-Level Significant Weather Prognostic Chart valid for 0100 and available for briefing prior to the accident depicted the cold front moving across southern Florida with an extensive area of IMC expected over most of all of Florida, Georgia, South Carolina, Alabama, and into sections of Mississippi, and Tennessee. The chart depicted no significant turbulence outside of convective activity was expected, and depicted the freezing level near 12,000 feet over the region.

No weather reporting capability was present at X50. A review of the observations surrounding the area indicated that at the time the accident airplane departed from X50, IMC were already being reported surrounding the area at EVB, DAB, and to the south at the NASA Shuttle Landing Facility (TTS), Titusville, Florida.

EVB was located approximately 5 nm north of the departure airport at an elevation of 10 feet, and less than 3 miles west of the accident site. The airport had an Automated Weather Observation System. The weather conditions reported at 2055, or about 3 minutes prior the accident, included wind from 350° at 8 knots, visibility 8 statute miles, ceiling overcast at 500 feet, temperature 17° Celsius (C), dew point 16° C, altimeter 30.14 inches of mercury (Hg).

The next closest weather reporting station was DAB, located approximately 14 nm northwest of the departure airport at an elevation of 34 feet. The airport had a control tower and a federally installed and maintained Automated Surface Observation System (ASOS). The weather conditions reported at 2053, or about 5 minutes prior the accident, included wind from 020° at 9 knots, visibility 10 statute miles, ceiling overcast at 700 feet, temperature 18° C, dew point 16° C, and altimeter 30.14 inches of Hg.

The DAB special weather report at 2131 included wind from 360° at 11 knots gusting to 17 knots, visibility 1 statute mile, ceiling overcast at 400 feet, temperature 16° C, dew point 15° C, and altimeter 30.15 inches of Hg.

The DAB special weather report at 2146 included wind from 360° at 8 knots, visibility ½ statute mile in fog, ceiling overcast at 300 feet, temperature 16° C, dew point 15° C, and altimeter 30.15 inches of mercury. Remarks: automated observation system, tower visibility 1-mile, temperature 15.6° C, dew point 15.0° C.

Orlando Sanford International Airport (SFB), Orlando, Florida, was located 20 nm southwest of the departure airport at an elevation of 55 feet, and was equipped with an ASOS. The weather conditions reported at SFB, at 2100, included wind from 360° at 9 knots, visibility 10 statute miles, ceiling broken at 1,000 feet, overcast at 3,900 feet, temperature 19° C, dew point 17° C, altimeter 30.14 inches of Hg.

On the day of the accident, sunset occurred about 1745 and evening civil twilight occurred about 1811. Moonrise occurred at 0029, and moonset occurred at 1212.

The DAB North Controller, who assisted the accident controller, solicited pilot reports (PIREPS) for the DAB local area earlier in her shift, but could not recall their specific content. During the accident sequence, she had been working a Cirrus SR22, whose pilot requested the RNAV runway 29 approach into EVB. The SR22 was at 3,000 feet holding at RISRE, about 10 NM east of EVB and near the accident aircraft, but she did not solicit a PIREP from the pilot or ask about cloud tops.

COMMUNICATIONS

Paragraphs 10-2-8 and 10-2-9 of FAA order 7110.65 address how air traffic controllers should provide radar assistance to aircraft operating under visual flight rules (VFR) in weather difficulty, including techniques that should be used to the extent possible when providing assistance. They state [in part]:

10-2-8. RADAR ASSISTANCE TO VFR AIRCRAFT IN WEATHER DIFFICULTY

a. If a VFR aircraft requests radar assistance when it encounters or is about to encounter IFR weather conditions, ask the pilot if he/she is qualified for and capable of conducting IFR flight.

b. If the pilot states he/she is qualified for and capable of IFR flight, request him/her to file an IFR flight plan and then issue clearance to destination airport, as appropriate.

c. If the pilot states he/she is not qualified for or not capable of conducting IFR flight, or if he/she refuses to file an IFR flight plan, take whichever of the following actions is appropriate:

1. Inform the pilot of airports where VFR conditions are reported, provide other available pertinent weather information, and ask if he/she will elect to conduct VFR flight to such an airport.

2. If the action in subparagraph 1 above is not feasible or the pilot declines to conduct VFR flight to another airport, provide radar assistance if the pilot:

(a) Declares an emergency.

(b) Refuses to declare an emergency and you have determined the exact nature of the radar services the pilot desires.

3. If the aircraft has already encountered IFR conditions, inform the pilot of the appropriate terrain/obstacle clearance minimum altitude. If the aircraft is below appropriate terrain/obstacle clearance minimum altitude and sufficiently accurate position information has been received or radar identification is established, furnish a heading or radial on which to climb to reach appropriate terrain/obstacle clearance minimum altitude.

10-2-9. RADAR ASSISTANCE TECHNIQUES

Use the following techniques to the extent possible when you provide radar assistance to a pilot

NTSB Probable Cause

The pilot's failure to maintain control of the airplane while operating under visual flight rules (VFR) in night, instrument meteorological conditions, likely due to spatial disorientation. Contributing to the outcome was the radar controller's failure to follow published guidance for providing assistance to VFR pilots having difficulty flying in instrument conditions.